White Perkins Denise, Milan Pamela, Miazek Kimberly, Francis Ashley, Havstadb Suzanne, Bossick Andrew S, Wegienka Ganesa
Department of Family Medicine, Henry Ford Health, One Ford Place, Detroit, MI 48202, USA.
Department of Public Health Sciences, Henry Ford Health, One Ford Place, Detroit, MI 48202, USA.
Prev Med Rep. 2024 Feb 27;40:102671. doi: 10.1016/j.pmedr.2024.102671. eCollection 2024 Apr.
The American Diabetes Association has recommended that diabetes self-management education and support (DSMES) teams improve diabetes outcomes by identifying and responding to patients' social needs. This study examines demographic patterns in how hemoglobin A1c (A1c) is related to individual social needs, reported urgency of those needs, and interest in obtaining assistance. A total of 1125 unique persons who had been referred for DSMES and had completed a social needs screener via our electronic medical record were included. The majority (51.9 %) had an A1c < 8 % at their most recent assessment and most respondents (52.5 %) reported having at least 1 unmet social need (n = 591), Those who reported having at least 1 social need, tended to have higher A1c levels compared with those who reported no social needs (median of 8.0 % versus 7.7 %; p < 0.05). Among Black individuals the associations were stronger (median A1c of 8.2 % among those with versus 7.2 % among those without a reported social need; p < 0.05). However, among White individuals, there was no difference in A1c between these two groups. Among those who reported a social need, those who also reported they needed assistance (35.7 %) tended to have higher A1c levels than those who did not (median 8.3 % versus 7.8 %; p < 0.10). This relationship did not vary by race. Ongoing study of the relationship between unmet social needs and glycemic control is warranted to help identify effective clinical workflows to help providers incorporate consideration of social needs into their medical decision making.
美国糖尿病协会建议，糖尿病自我管理教育与支持（DSMES）团队通过识别并回应患者的社会需求来改善糖尿病治疗效果。本研究调查了糖化血红蛋白（A1c）与个体社会需求的关系、所报告的这些需求的紧迫性以及获得援助的意愿方面的人口统计学模式。共有1125名被转介接受DSMES并通过我们的电子病历完成社会需求筛查的独特个体纳入研究。大多数（51.9%）在最近一次评估时A1c<8%，大多数受访者（52.5%）报告至少有1项未满足的社会需求（n = 591）。与报告没有社会需求的人相比，报告至少有1项社会需求的人A1c水平往往更高（中位数分别为8.0%和7.7%；p<0.05）。在黑人个体中，这种关联更强（报告有社会需求者的A1c中位数为8.2%，而报告无社会需求者为7.2%；p<0.05）。然而，在白人个体中，这两组之间的A1c没有差异。在报告有社会需求的人中，那些还报告需要援助的人（35.7%）的A1c水平往往高于那些不需要援助的人（中位数分别为8.3%和7.8%；p<0.10）。这种关系不因种族而异。有必要持续研究未满足的社会需求与血糖控制之间的关系，以帮助确定有效的临床工作流程，帮助医疗服务提供者在医疗决策中考虑社会需求。
