Predictors of Interest in Offered Social Care Assistance Among People with Uncontrolled Diabetes

摘要

Despite increasing resources dedicated to identifying and addressing social risks in health care settings, many patients screening positive for social risks either decline assistance or do not follow up with offered resources. This study assessed predictors of engagement with offered social care assistance through guided self-navigation or in-person assistance. Data came from a cross-sectional analysis of 6-month follow-up survey data from an ongoing trial of participants with poorly controlled diabetes and a positive social risk screen randomized to guided online self-navigation or in-person social care assistance. Multivariable logistic regression models estimated participant characteristics associated with engagement with offered assistance. Mean age was 55 years (standard deviation = 12). Of 407 participants, 41 (n = 165) engaged with offered assistance: 76 (n = 137) of those in the guided self-navigation arm and 13 (n = 28) of those in the in-person assistance arm. A sizable proportion of participants endorsed already using assistance for medications (30), food (26), and employment (22). Female gender OR 1.57, 95 CI (1.03-2.40), P < 0.05 and being out of the workforce OR 1.71, 95 CI (1.07-2.73), P < 0.05 predicted engagement with social care assistance. Those already using assistance for medications OR 4.71, 95 CI (1.69-13.15), P < 0.05 and blood glucose supplies OR 6.25, 95 CI (1.45-26.78) P < 0.05 were also more likely to engage with offered assistance. Fewer than half of individuals engaged with offered social assistance through either guided online self-navigation or in-person assistance; limited demographic and clinical factors predicted uptake. More investments are needed to understand how best to support uptake of offered assistance.