Improvement in Psychosocial Functioning of Youth with Diabetes and Their Caregivers with Multiple Social Risk Factors

Background: Social determinants of health (SDOH) lead to health disparities. Novel Interventions in Children's Healthcare (NICH) is a community-based program for youth with chronic conditions such as diabetes, with a high degree of social risk. We describe changes in depressive symptoms, diabetes distress, and diabetes strengths in youth with diabetes and their caregivers who completed one year in NICH at UCSF. Methods: NICH participants in this analysis had diabetes and were ≥12 years old. All completed the Patient Health Questionnaire-8 (PHQ-8), Problem Area in Diabetes-Teen (PAID-T), and those ≥14 years completed the Diabetes Strength and Resilience measure for adolescents (DSTAR-Teen) at baseline and one year. Caregivers completed the parent PAID-T (P-PAID-T). Paired t-tests were used to compare scores at baseline and one year when scores for both time points were available. Results: Participants included 15 youth with type 1 and 1 with type 2 diabetes. Mean age was 15.4 ± 1.6 years, 88% were from historically marginalized racial or ethnic groups, and 94% had public insurance. Families had a mean of 8 ± 4.8 social risk factors at baseline, the most common being educational barriers, mental health needs, and trauma. Mean PHQ-8 scores decreased from 8.4 ± 6.4 at baseline to 4.3 ± 5.4 at one year (p=0.014, n=10). Mean PAID-T scores trended towards decreasing from baseline (70.7 ± 19.8) to one year (58.8 ± 22.9, p=0.24, n=10), and mean P-PAID-T scores significantly decreased from 57.3 ± 17.8 to 45.3 ± 16.8 (p=0.044, n=6). Mean DSTAR-Teen scores increased from 44.6 ± 6.3 to 48.9 ± 8.1 at one year (p=0.065, n=8). Conclusions: Participation in NICH is associated with fewer depressive symptoms, less caregiver diabetes distress, and a trend towards reduced distress in youth and improved diabetes-specific strengths. Further research on SDOH among underrepresented populations is needed, as interventions mitigating social risk have potential to improve psychosocial outcomes. Disclosure A.Reed: None. M.A.Harris: None. M.Lodish: None. J.C.Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. C.E.Noya: None. D.V.Wagner: None. J.H.Lim: None. V.Glocker: None. K.S.Bal: None. M.Gonzales granados: None. A.Stone: None. M.T.Mcgrath: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust