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T1DX-QI is a network of over 40 pediatric and adult centers that share best practices to improve outcomes for people with T1D. Guidelines for comprehensive diabetes care recommend integration of psychosocial screening; however, variable resources and clinical structures influence the degree to which practices can implement these recommendations.
A 22-item survey was administered to T1DX-QI sites in 2021 (n= 25 pediatric and 8 adult) . Data from items relevant to psychosocial screening were analyzed with Rstudio. Fisher tests were used to compare the percentage of psychosocial domains assessed by pediatric vs. adult clinics.
Overall, 96% of pediatric centers report using at least one screening tool, 79% report > 2; 43% of adult centers use one or more screening tools. The most common psychosocial domain in both settings is depression; pediatric (96%) , adult (38%) (Figure) . Screening for social determinants of health and diabetes-related distress were reported in both settings, and unique to pediatric is assessment of readiness to transition to adult care.
Varying degrees of psychosocial screening is present in the T1DX-QI network. Centers endorse benefits, as well as common challenges, including time constraints, integration into workflow, and how best to follow up responses. T1DX-QI sites are working together to overcome barriers that contribute to gaps between guidelines and practice.
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