P-282: Screening for social drivers of health: discrepancies in clinical- and Research-Based reporting
D N Williford, S Castillo, S D Corathers, N -H Yayah JonesAbstract
Introduction
Few teens with type 1 diabetes (T1D) meet glycemic goals, in part due to social drivers of health (SDOH). Guidelines recommend routine SDOH screening, yet substantial variation exists in tools and domains assessed.
Objectives
This study examined discrepancies in SDOH reporting between research and clinical contexts within a shared population of teens with T1D.
Methods
Seventy teens with T1D (13-17 years, M=15.7; Female=41%; White=71%, Black=21%, Hispanic/Latine=1.4%; HbA1c M=8.7%) and a caregiver were enrolled. Research Measures (Self-Report): Background Information Form (study-specific demographics); SDOH Screening Questions (study-adapted SDOH), U.S. Household food Security Survey Module (food security). Clinical Measures (Chart Review): Your Needs Matter screening tool (SDOH), insurance status, and clinical information (i.e., HbA1c).
Results
All families completed clinical SDOH screening, with 40% (n=28) endorsing at least 1 adverse SDOH. Most reported 1-2 adverse SDOH, most commonly financial strain (n=13, 18.6%), caregiver education/health literacy concerns (n=9, 12.9%), or food insecurity (n=7, 10.0%). In contrast, research-based SDOH screening identified a higher prevalence, with 56.4% (n=31) endorsing at least 1 adverse SDOH; most families reported 1-2 adverse SDOH (n=48, 87.3%). The domains most frequently endorsed in research screening were food security (n=38, 54.3%), challenges with public benefits (e.g., food stamps or insurance; n=28, 40.0%) or utility concerns (n=8, 11.4%).
Conclusions
Although research settings allow more comprehensive assessment of SDOH, findings indicate higher SDOH endorsement in research compared to clinical screening, even for similar domains. This discrepancy may reflect concerns about how SDOH disclosure could affect clinical care. These findings underscore the importance of researcher–clinician partnerships to more accurately identify and address patients’ social needs.