About this trial

The goal of this clinical trial is to learn if the implementation of the WE CARE social determinants of health (SDOH) screening and referral intervention with an antiracist lens in primary care settings can lead to a meaningful decrease in chronic disease by monitoring conditions such as hypertension, diabetes, depression, hyperlipidemia, and asthma through clinical measures. The main question it aims to answer is:

Does the WE CARE SDOH screening and referral intervention applying an antiracism lens informed implementation strategies have the potential to reduce racial/ethnic health inequities in chronic diseases for minoritized patients?

Eligibility criteria

Qualifiers

Adults and children with diagnosed chronic diseases (hypertension, diabetes mellitus, hyperlipidemia, asthma, or depression) who receive Family Medicine care at one of the study sites.

Children (<18 years of age) with a diagnosis of asthma.

Adult patients (18 years or older) with a diagnosis of diabetes mellitus, hypertension, hyperlipidemia and/or depression.

Disqualifiers

In adults (>18 years of age), those without one or more of the following diagnoses as recorded by ICD-10 codes in their EHR: hypertension, hyperlipidemia, diabetes mellitus, or depression.

In children (<18 years of age), those without a diagnosis of asthma.

Trial design

Treatments tested in this trial

  • WE CARE SDOH System
  • Standard Pediatric Care

Treatment groups

68,000 Participants
are divided into 2 treatment groups

Locations

3
Family Health Center of Worcester01610, WorcesterMassachusetts, United States
UMass Memorial Medical Center - Hahnemann Campus01605, WorcesterMassachusetts, United States
UMass Memorial Medical Center -Benedict Family Medicine Clinic01655, WorcesterMassachusetts, United States

Sponsors and collaborators

University of Massachusetts, Worcester

Lead sponsor

National Institute of Nursing Research (NINR)

Collaborator

Boston University

Collaborator

Boston Medical Center

Collaborator

Family Health Center of Worcester

Collaborator