New CHAPTers in Diabetes: A Pilot Study of Community Health Worker Assisted Pediatric Transition to Adult Care for Emerging Adults with Type 2 Diabetes
Statement of Problem
Youth with type 2 diabetes often slip through the cracks in the transition from child to adult care. Gaps in care for these emerging adults can have serious health consequences, including worsening glycemic index and diabetes-related complications.
While 16% of youth with type 2 diabetes were uninsured in the two years after transitioning to adult care, one third of those with coverage were disengaged from their outpatient adult diabetic care. For the disproportionate number of emerging adults with type 2 diabetes from minoritized groups or low-income households, accessing adult care may be further complicated by social determinants of health like financial stress and food insecurity.
Research has shown that community health workers (CHWs) can act as guides during transitions and even improve health outcomes among minoritized or low-income adults. But the impact of CHWs on emerging adults with type 2 diabetes has not yet been studied.
Description
Prior work by our study team has demonstrated that emerging adults with diabetes and their families are interested in support during the transition to adult care. This study will pilot an intervention where CHWs work with outpatient emerging adults with type 2 diabetes identified by electronic health records to develop a personalized care plan to address specific transition-related needs. Over the course of the 12-month intervention, CHWs will call and text to check in on the emerging adults’ health-related goals and their access to resources and education.
Through a randomized controlled trial, we aim to:
- Adapt and deliver this intervention for emerging adults with type 2 diabetes
- Gather feedback about the program from participants, CHWs, social workers and providers to inform a future hybrid-effectiveness implementation trial
- Begin to explore the intervention’s efficacy and effect on glycemic control, diabetes-related quality of life and self-rated physical health
Next Steps
We look forward to implementing evidence from this trial to develop a type 1 hybrid-effectiveness implementation trial to test the effectiveness of the program on successful transition to adult diabetic care and improved glycemic control.
The ultimate goal of this project is to improve access to care and serve as a model for future CHW transition interventions that aim to address health disparities, prevent disease-related complications and achieve remission for the growing number of emerging adults with type 2 diabetes.
Suggested Citation
Children's Hospital of Philadelphia, PolicyLab. New CHAPTers in Diabetes: A Pilot Study of Community Health Worker Assisted Pediatric Transition to Adult Care for Emerging Adults with Type 2 Diabetes [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].