Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( 🔒 ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Need Help

Addressing Social Determinants of Health in Young Adults with Type 1 Diabetes Through Comprehensive Assessment, Responsiveness, and Engagement (T1CARE)

Award Number: R01DK139558
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 01/28/2025
PERIOD OF PERFORMANCE END DATE: 12/31/2027

Group Awards By:

View Award Description

Addressing Social Determinants of Health in Young Adults with Type 1 Diabetes Through Comprehensive Assessment, Responsiveness, and Engagement (T1CARE) - ABSTRACT Adverse social determinants of health constitute major barriers to type 1 diabetes (T1D) management and drive disparities in diabetes outcomes. Young adults with T1D tend to have the worst glycemic control levels of all age groups, with Black and Hispanic young adults experiencing the highest complication rates and mortality. While social risk factor screening-and-referral services could improve health outcomes, convincing data on their effectiveness are largely lacking. Results from the Accountable Health Communities Model found this intervention ineffective with respect to addressing social needs. As opposed to classifying people by social risk factors and assisting them in accessing generic services, a personalized intervention, fully responsive to the complex, problematic situation of each person may be required, especially to address the unique needs of young patients with T1D. However, such an approach remains untested against care as usual. To fill this knowledge and care gap, we propose a pilot randomized trial to test the feasibility and preliminary efficacy of T1CARE: Comprehensive Assessment Responsiveness and Engagement. T1CARE includes in-depth assessment of social and clinical needs and a hybrid community health worker-patient navigator approach to address social and clinical needs of young patients with T1D. We have partnered with a community-based organization (Project Access-New Haven), which has an established record of removing barriers to clinical care and addressing social needs for underserved populations. Our specific aims are: Aim 1: Determine the feasibility of implementing screening for adverse social determinants of health (SDOH) for young patients with T1D and randomly linking patients who report ≥1 adverse SDOH to either T1CARE or usual care: (1.1): Characterize what is the usual care these patients receive during the experimentation period to determine what aspects of the intervention are present usually, including “dose” and intensity. (1.2): Evaluate the feasibility of recruitment and retention of trial participants, rates of SDOH screening and identification of adverse SDOH, acceptability of the intervention, completion of study procedures, and collection of clinical outcome data. (1.3): Assess the extent to which screening for SDOH and T1CARE can be integrated into clinical practice routines using Normalization Process Theory and its Toolkit. Aim 2: Estimate preliminary signals of the efficacy of T1CARE vs. usual care for the following outcomes at 6 months post intervention: (2.1) resolution of adverse SDOH; (2.2) patient-reported outcomes, including diabetes distress (measured using the Diabetes Distress Scale), illness intrusiveness (Illness Intrusiveness Scale), and global quality of life (evaluated using a 1-item analogue scale); and (2.3) clinical outcomes, specifically changes in HbA1c levels. This study will establish a robust partnership model with Project Access-New Haven, and estimate feasibility, normalization, and efficacy of an innovative approach, T1CARE, for testing in future larger hybrid effectiveness-implementation trials.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $468,180 )
2026	2026	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	12/30/2025	NON-COMPETING CONTINUATION	$468,180
														Subtotal = $468,180

Issue Date FY: 2025 ( Subtotal = $512,812 )
2025	2025	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	1/27/2025	NEW	$512,812
2025	2025	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	1	8/19/2025	NEW	$0
														Subtotal = $512,812

Grand Total All Awards = $980,992

Top

All Categories

About

Search

Reports

Data Submission

Award Information

Addressing Social Determinants of Health in Young Adults with Type 1 Diabetes Through Comprehensive Assessment, Responsiveness, and Engagement (T1CARE)

Award Number: R01DK139558

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 01/28/2025

PERIOD OF PERFORMANCE END DATE: 12/31/2027

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer