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Bringing Social Context into Diabetes Care: Intervening on Social Risks versus Providing Contextualized Care

  • Psychosocial Aspects (SS Jaser, Section Editor)
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Abstract

Purpose of Review

Patient social and economic risk information can guide diabetes care through social risk–targeted care (directly intervening on social risk factors) or social risk–informed care (modifying or tailoring care to accommodate social risks). We review evidence supporting these approaches and highlight critical gaps in the current evidence.

Recent Findings

Literature is scarce on isolated social care interventions and the impact on glycemic control is unclear, while blended social-behavioral interventions more consistently point to reductions in HbA1c. Social risk–informed care naturally occurs at low rates, yet holds potential to improve care.

Summary

Momentum is building around programs designed to intervene on social risk factors and/or to contextualize care based on social context. Future work will need to isolate the impacts of these programs, clarify the pathways through which social care programs can improve outcomes, and identify provider barriers and facilitators to using social risk information in care.

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Author information

Authors and Affiliations

  1. Department of Family and Community Medicine, University of California, San Francisco, Box 0900, San Francisco, CA, 94143, USA

    Danielle Hessler, Vicky Bowyer, Laura Shields-Zeeman & Laura M. Gottlieb

  2. Kaiser Permanente Center for Health Research, Portland, OR, USA

    Rachel Gold

  3. OCHIN Inc., Portland, OR, USA

    Rachel Gold & Erika Cottrell

Authors
  1. Danielle Hessler
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  2. Vicky Bowyer
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  3. Rachel Gold
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  4. Laura Shields-Zeeman
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  5. Erika Cottrell
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  6. Laura M. Gottlieb
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Correspondence to Danielle Hessler.

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Danielle Hessler, Vicky Bowyer, Rachel Gold, Laura Shields-Zeeman, Erika Cottrell, and L.M. Gottlieb declare that they have no conflict of interest.

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Hessler, D., Bowyer, V., Gold, R. et al. Bringing Social Context into Diabetes Care: Intervening on Social Risks versus Providing Contextualized Care. Curr Diab Rep 19, 30 (2019). https://doi.org/10.1007/s11892-019-1149-y

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