Title
Leveraging Social Needs Assessments to Eliminate Barriers to Diabetes Self-Management in a Vulnerable Population
Authors
Jennifer Odoi, Wei-Chen Lee, Hani Serag, Monica Hernandez, Savannah Parks, Sara B. Siddiqui, Laura C. Pinheiro, Randall Urban, and Hanaa S. Sallam
Journal
International Journal of Environmental Research and Public Health
Abstract
This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) | Program at St. Vincent's House Clinic, a primary care practice serving resource- challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non- medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA
narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were
occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as
tertiary prevention to mitigate diabetes-related complications and disparities.