Publications

Improving Health Equity Through the T1D Exchange QI Collaborative

Written by T1D Exchange | Jun 11, 2026 6:22:00 PM

Common Barriers to Health Equity and Factors Actively Addressed to Improve Health Equity in the Type 1 Diabetes Exchange QI Collaborative

 

Author Block: TREVON WRIGHT, SUSAN THAPA, NICOLE RIOLES, JENISE C. WONG, KAJAL GANDHI, NANA-HAWA YAYAH JONES, JANINE SANCHEZ, ORI ODUGBESAN, ASHLEY BUTLER, SELORM DEI-TUTU, Boston, MA, San Francisco, CA, Columbus, OH, Cincinnati, OH, Miami, FL, Houston, TX

Introduction and Objective: Health inequities continue to drive disparities in diabetes outcomes across the United States. To help identify barriers to facilitators of health equity improvement, the T1D Exchange QI Collaborative conducted an assessment of member centers.

Methods: The annual T1DX-QI survey was administered via Qualtrics from August to October 2025 to collect data from 2023. It has 12 sections and 79 questions. Descriptive analyses compared responses from adult and pediatric diabetes centers.


Results: Ninety- three percent of pediatric centers indicated that they addressed health equity. Survey results showed patient-level barriers that included limited access to diabetes technology (adult 57%; pediatric 60%), food insecurity (adult 67%; pediatric 74%), and transportation challenges (adult 52%; pediatric 88%). Pediatric centers more often implemented structured equity-focused practices, including trainee equity education (81% vs 67%), social determinants of health (SDOH) screening (79% vs 52%), and standardized SDOH documentation (71% vs 52%) Adult centers reported more challenges to collaboration and SDOH documentation.


Conclusion: Pediatric centers reported frequent implementation of structured, system-level strategies, that support opportunities for shared decision making and learning compared to adult centers.


 

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