Leveraging Community-clinical Linkages to Address Unmet Social Needs for People With Diabetes Living in Rural Settings
Mary Lacy
Summary
This study is a hybrid type 2 design to evaluate the effectiveness and implementation of a community-clinical linkage intervention in primary clinics to address unmet social needs for patients with diabetes living in rural communities. The study will take place in two rural communities in Kentucky, one in eastern Kentucky and one in western Kentucky.
Description
This study will convene clinical and community partners to complete a rapid process improvement workshop (RPIW) to co-create scalable strategies to address unmet social needs and to implement the developed strategy in primary care clinics in two rural communities in Kentucky. Results from the RPIW will be used to design an implementation template with specific implementation strategies tailored to each unique community-clinical linkage (CCL). While implementation strategies will be tailored to each CCL, the overarching intervention components for all CCL include: 1) patient navigators; 2) heal…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Clinic/Staff Inclusion Criteria: * staff at the intervention or comparison clinic Participant Inclusion Criteria: * age 18 or older, * is a patient at the intervention or comparison clinic * diagnosed with diabetes Clinic/Staff Exclusion Criteria: * staff not at the intervention or comparison clinic Participant Exclusion Criteria: * being under the age of 18, * not a patient at the intervention or comparison clinic * not diagnosed with diabetes
Interventions
- BehavioralCommunity-Clinical Intervention
The intervention involves enhancing usual care for screening patients with diabetes for unmet social needs and referring those who screen positive to a Community Health Worker. Patients who screen positive for unmet social needs will work with CHWs to be connected to community organizations.
Location
- University of KentuckyLexington, Kentucky