Addressing Social Determinants in Diabetes Care: the REDD-CAT health-related social needs screening tool

解决糖尿病护理中的社会决定因素：REDD-CAT 健康相关社会需求筛查工具

• 批准号: 9913522
• 负责人: Noelle E. Carlozzi
• 金额: $ 29.15万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-11 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9913522
• 关键词: Accident and Emergency department; Accounting; Achievement; Address; Adoption; Algorithms; American; Assessment tool; Automobile Driving; Caring; Chronic Disease; Clinical; Communities; Complications of Diabetes Mellitus; Computers; Data; Data Collection; Data Sources; Diabetes Mellitus; Diagnosis; Emergency department visit; Engineering; Face; Feasibility Studies; Food; Future; Goals; Health; Health Care Costs; Health Professional; Hospitalization; Hospitals; Housing; Income; Individual; Information Systems; Interview; Link; Measurement; Measures; Medical Records; Methods; Names; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patient Outcomes Assessments; Patients; Persons; Pharmaceutical Preparations; Play; Process; Quality of Care; Randomized Controlled Trials; Research; Resources; Review Literature; Risk; Risk Assessment; Role; Screening procedure; Social Work; Social support; Societal Factors; Surveys; System; Technology; Testing; Time; Treatment Efficacy; Triage; United States National Institutes of Health; Violence; Weight; Work; base; burden of illness; care costs; clinical care; design; diabetes self-management; feasibility trial; food insecurity; health care availability; health seeking behavior; high risk; hospital readmission; housing instability; improved; member; point of care; predictive tools; prevent; prospective; randomized trial; readmission risk; response; social; social determinants; social factors; social health determinants; tool

PROJECT SUMMARY Over 27 million Americans have Type 2 Diabetes Mellitus (T2DM), accounting for more than 7.7 million hospital admissions and $245 billion in healthcare costs each year. Hospitalized T2DM patients are at increased risk of readmission; in 2010, 20.3% of patients admitted for DM with complications were readmitted within 30 days, making diabetes one of the top conditions for rehospitalizations. In many instances, the social determinants of health—such as housing and food instability, benefits denials, and lack of income—are responsible for preventable hospitalizations, as they undermine the patient’s ability to self-manage diabetes and prevent complications. Often these unmet social needs are informally identified in the course of clinical care. However, there is no streamlined process to comprehensively identify, prioritize, and address the most important health-related social needs of our most vulnerable patients. Our previous research has increased our understanding of the multitude of social determinants related to readmission risk and poor outcomes. It has underscored the importance of developing methods to efficiently assess and prioritize social determinants and to develop profiles of the individuals at the highest risk of readmission. We propose to develop a measurement system, Re-Engineered Discharge for Diabetes-Computer Adaptive Testing (REDD-CAT) to efficiently capture and create a personalized profile of health-related social needs for patients with diabetes to reduce avoidable hospitalization and emergency department visits. Our aims are: 1) to develop and validate the REDD-CAT; 2) to utilize the newly developed REDD-CAT measures, existing measures from PROMIS, medical record data, and retrospective claims data to generate personalized risk assessment profiles; and 3) to conduct a pilot feasibility trial to assess the acceptability of implementing the REDD-CAT in a clinical context. Achievement of these three aims will set the stage for a prospective, randomized trial of the REDD-CAT implementation in a hospital setting to assess its impact on 30-day readmissions. As the name of our proposed assessment tool implies, the longer-term goal of our research is to create a process for the Re-Engineered Discharge for Diabetes and to embed the REDD-CAT in this process as the primary data source. Ultimately, we anticipate that the methods we use to research and develop the REDD-CAT will find wide application across a number of different settings and chronic diseases.

项目摘要 超过2700万美国人患有2型糖尿病（T2DM），占770万 医院入院和2450亿美元的医疗保健费用。住院的T2DM患者处于 增加再入院风险； 2010年，有20.3％的患者患有并发症的DM患者 在30天之内，使糖尿病成为重新住院的首要条件之一。在许多情况下，社会 确定健康，例如住房和食品不稳定，否认罪和缺乏收入 - 负责可预防的住院治疗，因为它们破坏了患者的自我控制糖尿病的能力 并防止并发症。通常，这些未满足的社会需求在临床过程中非正式地确定 关心。但是，没有简化的过程可以全面识别，优先级和解决最多的问题 我们最脆弱的患者的重要健康相关社会需求。我们以前的研究增加了我们的 了解与再入院风险和不良结果有关的众多社会决定者。它有 强调开发有效评估和优先级社会决定者和优先级的方法的重要性 开发以最高再入院风险的个人的个人资料。我们建议开发测量 系统，重新设计的糖尿病 - 计算机自适应测试（REDD-CAT）的排放量有效捕获 并为糖尿病患者创建与健康相关的社会需求的个性化概况，以减少可避免的 住院和急诊室就诊。我们的目标是：1）开发和验证Redd-cat； 2） 利用新开发的Redd-cat测量结果，现有的测量值，医疗记录数据， 回顾性索赔数据以生成个性化的风险评估概况； 3）进行飞行员 可行性试验，以评估在临床背景下实施REDD-CAT的可接受性。成就 这三个目标将为Redd-cat实施的前瞻性，随机试验奠定了基础 医院设置以评估其对30天再入院的影响。作为我们提议的评估工具的名称 暗示我们研究的长期目标是为重新设计的放电创建一个过程 糖尿病并将REDD-CAT嵌入此过程中，作为主要数据源。最终，我们期望 我们用来研究和开发Redd-cat的方法将在许多范围内找到广泛的应用 不同的环境和慢性疾病。

项目成果

The Physical Activity Assessment of Adults With Type 2 Diabetes Using Accelerometer-Based Cut Points: Scoping Review.

• DOI: 10.2196/34433
• 发表时间: 2022-09-06
• 期刊: INTERACTIVE JOURNAL OF MEDICAL RESEARCH
• 影响因子: 2
• 作者: Moldovan, Ioana A.;Bragg, Alexa;Nidhiry, Anna S.;De La Cruz, Barbara A.;Mitchell, Suzanne E.
• 通讯作者: Mitchell, Suzanne E.