TY - JOUR
T1 - Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes
AU - McQueen, Amy
AU - Kreuter, Matthew W.
AU - Herrick, Cynthia J.
AU - Li, Linda
AU - Brown, Derek S.
AU - Haire-Joshu, Debra
N1 - Funding Information:
This research was supported by a pilot grant award (PI: McQueen) from the Washington University Center for Diabetes Translation Research (P30DK092950 PI: Haire-Joshu) and subsequent grant 1R01DK115916-01 (MPI: McQueen & Kreuter). Special thanks go to our participants who shared their time and to our survey interviewers Vineet Raman, Erika Halsey, Paulina Flores Jimenez, and Elle Warshaw. The study benefited from collaborators from Washington University partnerships with the Centene Center for Health Transformation (Karyn Quinn, Lisa Gibson), Centene Corporation (Ginny Barr, Scott Lantz), and Louisiana Healthcare Connections (Kendra Case, Delanie Bachman). Analytic support with claims data was received from Matthew Keller and Margaret Olsen at the Center for Administrative Data Research at Washington University, which is supported by ICTS grant UL1 TR002345 and AHRQ grant R24 HS19455. Procedures and preliminary findings were presented at the annual Society of Behavioral Medicine conference April 2018, New Orleans LA.
Funding Information:
This research was supported by a pilot grant award (PI: McQueen) from the Washington University Center for Diabetes Translation Research (P30DK092950 PI: Haire‐Joshu) and subsequent grant 1R01DK115916‐01 (MPI: McQueen & Kreuter). Special thanks go to our participants who shared their time and to our survey interviewers Vineet Raman, Erika Halsey, Paulina Flores Jimenez, and Elle Warshaw. The study benefited from collaborators from Washington University partnerships with the Centene Center for Health Transformation (Karyn Quinn, Lisa Gibson), Centene Corporation (Ginny Barr, Scott Lantz), and Louisiana Healthcare Connections (Kendra Case, Delanie Bachman). Analytic support with claims data was received from Matthew Keller and Margaret Olsen at the Center for Administrative Data Research at Washington University, which is supported by ICTS grant UL1 TR002345 and AHRQ grant R24 HS19455. Procedures and preliminary findings were presented at the annual Society of Behavioral Medicine conference April 2018, New Orleans LA.
Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2022/5
Y1 - 2022/5
N2 - The purpose of this study was to better understand the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes, and how their social needs are associated with key health indicators. Also examined were factors that influence patients’ interest in navigation services for health and social needs to inform future interventions and service delivery. The study expands upon prior research, much of which has focused on only one social need (e.g., food insecurity) or one health outcome. The hypothesis was that among individuals with type 2 diabetes, those with a greater number of social needs would report more health-related problems and be more interested in receiving social needs navigation services. Participants completed a cross-sectional survey by phone (n = 95) or online (n = 14). Most (85%) reported having at least one social need (M = 2.5, SD = 2.2), most commonly not having enough money for unexpected expenses (68%) or necessities like food, shelter and clothing (31%), medical costs (24%), and utilities (23%). Results supported our comprehensive conceptual model. Having more social needs was associated with greater perceived stress, diabetes distress, problems with sleep and executive and cognitive functioning, less frequent diabetes self-care activities, more days of poor mental health and activity limitations, worse self-reported health and more hospitalisations. Number of social needs also was positively associated with interest in having a social needs navigator. Social needs were not associated with days of poor physical health, BMI, self-reported A1C or smoking status. Social needs were associated with a wide range of indicators of poor health and well-being. Participants with the greatest social need burden were most open to intervention.
AB - The purpose of this study was to better understand the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes, and how their social needs are associated with key health indicators. Also examined were factors that influence patients’ interest in navigation services for health and social needs to inform future interventions and service delivery. The study expands upon prior research, much of which has focused on only one social need (e.g., food insecurity) or one health outcome. The hypothesis was that among individuals with type 2 diabetes, those with a greater number of social needs would report more health-related problems and be more interested in receiving social needs navigation services. Participants completed a cross-sectional survey by phone (n = 95) or online (n = 14). Most (85%) reported having at least one social need (M = 2.5, SD = 2.2), most commonly not having enough money for unexpected expenses (68%) or necessities like food, shelter and clothing (31%), medical costs (24%), and utilities (23%). Results supported our comprehensive conceptual model. Having more social needs was associated with greater perceived stress, diabetes distress, problems with sleep and executive and cognitive functioning, less frequent diabetes self-care activities, more days of poor mental health and activity limitations, worse self-reported health and more hospitalisations. Number of social needs also was positively associated with interest in having a social needs navigator. Social needs were not associated with days of poor physical health, BMI, self-reported A1C or smoking status. Social needs were associated with a wide range of indicators of poor health and well-being. Participants with the greatest social need burden were most open to intervention.
KW - health education
KW - health services marketing
KW - holistic health
KW - low-income population
KW - patient navigators
KW - social determinants of health
KW - type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85102281048&partnerID=8YFLogxK
U2 - 10.1111/hsc.13296
DO - 10.1111/hsc.13296
M3 - Article
C2 - 33704849
AN - SCOPUS:85102281048
SN - 0966-0410
VL - 30
SP - 1035
EP - 1044
JO - Health and Social Care in the Community
JF - Health and Social Care in the Community
IS - 3
ER -