150-LB: Diabetes and School Health (DASH) Program—An Innovative School-Based Health Model to Optimize Care for Youth with Type 1 Diabetes

Abstract

Objectives: Pediatric type 1 diabetes (T1D) care requires collaboration of families, diabetes team and caregivers. Youth spend most of the time in school so care optimization in school is crucial. There are no evidence-based guidelines for school-based care, and management varies based on local legislation, school district, and staffing. An innovative school-based program provides an opportunity to standardize care, improve outcomes, reduce inequities, and inform guidelines for school T1D care. Methods: The Nationwide Children's Hospital (NCH) Diabetes and School Health (DASH) program is a novel school-based intervention. The intradisciplinary DASH team provides on-site education to students/staff, addresses medical/psychosocial concerns, coordinates delivery of medications/supplies, and facilitates communication. The pilot aimed to enroll 50 students identified as high risk based on their Diabetes Composite Score, a risk assessment tool developed by NCH. Qualitative and quantitative data was obtained for students, caregivers, and staff, including A1C, acute care utilization, educational mastery, quality of life, psychosocial, and health equity measures. Results: 50 students over 35 schools enrolled in the pilot. The majority used injections, 50% never used a continuous glucose monitor, and the average baseline A1C was 12%. More than 60% identified as an ethnic minority. Survey data showed over 50% of students felt others did not appreciate the burden of T1D care and endorsed T1D "burn out." Over 50% of caregivers endorsed feeling defeated/discouraged by T1D care, and worry about T1D related complications. Conclusions: DASH is a novel school-based program that provides support, education, and oversight to students at high risk of T1D complications. The program aims to standardize school-based care, empower school staff, improve self-efficacy, address inequities, decrease T1D complications and provide a framework for school based care. Disclosure A. C. H. Wood: None. A. M. Moffett: None. K. Simms: None. M. Moore: None. E. Suli: None. M. K. Irwin: None. E. Edwards: None. K. Gandhi: None.