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

Amy McQueen (), David von Nordheim, Charlene Caburnay, Linda Li, Cynthia Herrick, Lauren Grimes, Darrell Broussard, Rachel E. Smith, Dana Lawson, Yan Yan and Matthew Kreuter
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Amy McQueen: School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, 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
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

IJERPH, 2024, vol. 21, issue 7, 1-17

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.

Keywords: Medicaid; low-income population; chronic disease; social needs; intervention; randomized controlled trial (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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