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A Randomized Controlled Trial Testing the Effects of a Social Needs Navigation Intervention on Health Outcomes and Healthcare Utilization among Medicaid Members with Type 2 Diabetes

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  • Amy McQueen

    (School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, USA
    Health Communication Research Lab, Brown School, Washington University in St. Louis, 1 Brookings Hall, St. Louis, MO 63130, USA)

  • David von Nordheim

    (Health Communication Research Lab, Brown School, Washington University in St. Louis, 1 Brookings Hall, St. Louis, MO 63130, USA)

  • Charlene Caburnay

    (Health Communication Research Lab, Brown School, Washington University in St. Louis, 1 Brookings Hall, St. Louis, MO 63130, USA)

  • Linda Li

    (Health Communication Research Lab, Brown School, Washington University in St. Louis, 1 Brookings Hall, St. Louis, MO 63130, USA)

  • Cynthia Herrick

    (School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, USA)

  • Lauren Grimes

    (Health Communication Research Lab, Brown School, Washington University in St. Louis, 1 Brookings Hall, St. Louis, MO 63130, USA)

  • Darrell Broussard

    (Louisiana Healthcare Connections, 4171 Essen Ln, 2nd floor, Baton Rouge, LA 70809, USA
    CGI Federal, 538 Cajundome Boulevard, Lafayette, LA 70506, USA)

  • Rachel E. Smith

    (Louisiana Healthcare Connections, 4171 Essen Ln, 2nd floor, Baton Rouge, LA 70809, USA)

  • Dana Lawson

    (Louisiana Healthcare Connections, 4171 Essen Ln, 2nd floor, Baton Rouge, LA 70809, USA)

  • Yan Yan

    (School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, USA)

  • Matthew Kreuter

    (Health Communication Research Lab, Brown School, Washington University in St. Louis, 1 Brookings Hall, St. Louis, MO 63130, USA)

Abstract

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care ( n = 239) or social needs navigation ( n = 234) for 6 months and compare HbA1c (primary outcome), quality of life (secondary outcome), and other exploratory outcomes with t -tests and mixed-effects regression. Eligible participants had an HbA1c test in claims in the past 120 days and reported 1+ social needs. Data were collected from November 2019 to July 2023. Surveys were completed at baseline and at 3-, 6-, and 12-month follow-up. Health plan data included care management records and medical and pharmacy claims. The sample was from Louisiana, USA, M = 51.6 (SD = 9.5) years old, 76.1% female, 66.5% Black, 29.4% White, and 3.0% Hispanic. By design, more navigation (91.5%) vs. usual care (6.7%) participants had a care plan. Social needs persisted for both groups. No group differences in HbA1c tests and values were observed, though the large amount of missing HbA1c lab values reduced statistical power. No group differences were observed for other outcomes. Proactively eliciting and attempting to provide referrals and resources for social needs did not demonstrate significant health benefits or decrease healthcare utilization in this sample.

Suggested Citation

  • Amy McQueen & David von Nordheim & Charlene Caburnay & Linda Li & Cynthia Herrick & Lauren Grimes & Darrell Broussard & Rachel E. Smith & Dana Lawson & Yan Yan & Matthew Kreuter, 2024. "A Randomized Controlled Trial Testing the Effects of a Social Needs Navigation Intervention on Health Outcomes and Healthcare Utilization among Medicaid Members with Type 2 Diabetes," IJERPH, MDPI, vol. 21(7), pages 1-17, July.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:7:p:936-:d:1437852
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    References listed on IDEAS

    as
    1. M. Lelinneth B. Novilla & Michael C. Goates & Tyler Leffler & Nathan Kenneth B. Novilla & Chung-Yuan Wu & Alexa Dall & Cole Hansen, 2023. "Integrating Social Care into Healthcare: A Review on Applying the Social Determinants of Health in Clinical Settings," IJERPH, MDPI, vol. 20(19), pages 1-27, October.
    2. Lauren A Taylor & Annabel Xulin Tan & Caitlin E Coyle & Chima Ndumele & Erika Rogan & Maureen Canavan & Leslie A Curry & Elizabeth H Bradley, 2016. "Leveraging the Social Determinants of Health: What Works?," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-20, August.
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