O-35: Diabetes and school health (dash) program: 5 years of growth, lessons, and innovative and equitable diabetes care
K Gandhi, K Simms, M Miller, N Dawson, T Dachenhaus, A Jones, M K IrwinAbstract
Introduction
Diabetes and School Health (DASH) program is a novel health equity strategy and school-based program in its 5th program year.
Objectives
The growing program provides inter-disciplinary in-school type 1 diabetes care, providing collaborative education to staff, families and students with pharmaceutical support and delivery.
Methods
During DASH’s 5 years of operation, students have enrolled from schools in central Ohio. Students were recruited as moderate or high risk based on their Diabetes Composite Score, a novel risk assessment tool developed by NCH (score <13, indicating increased risk). Data was obtained from students, caregivers, and staff, including A1C, acute care utilization, medical outcomes, psychosocial, and health equity measures.
Results
Since the start of the DASH program, the team has served over 130 patients (84% minority) in 126 schools and 14 districts, through > 1600 school visits. Through the DASH program, average A1c improved from 12.4% to 9.4%, Diabetes Composite Score improved from 9 to 12, indicating decreased risk of complications, regular CGM use increased from 16% to 75%, and use of insulin pump technology increased from 9% to 47%. Among DASH patients, emergency room visits were reduced by 41%, urgent care visits reduced by 75%, and hospitalizations reduced by 55% from 2021-2023. Care coordination improved with 82% of DASH patients attending >3 diabetes appointments within 12 months and initiating telehealth visits. DASH program provided education sessions, media outreach/advocacy through state health collaboratives, and parenting/provider podcasts for more effective diabetes care policies.
Conclusions
DASH is a unique school-based health equity program which provides adaptive clinical care in the school setting involving care coordination and education to students at risk of adverse T1D outcomes. The program has been effective improving diabetes care, reducing acute care utilization, increasing utilization of diabetes technology and optimizing care coordination.