School Nurses and Telehealth Services as Social Determinant Pathway Disruptors for Youth Diagnosed with Type 1 Diabetes

Type 1 Diabetes (T1D) is the most common chronic disease diagnosed in youth. Individuals living with T1D face a multitude of social determinant disruptors that can result in negative health, and affect the outcomes and quality of their lives. These determinants include environment, economics, food security, social connections, and education.

Using the unique position of the school nurse, and coupling this with telehealth services, we can provide children with T1D the necessary tools to improve access to, and quality of their care. By increasing the responsibilities of school nurses and utilizing telehealth more efficiently, we can overcome the social determinant pathway disruptors. This change could increase the likelihood for sustained, positive, and holistic health outcomes related to management and resource availability for chronic disease management. School Nurses can utilize a multidimensional approach to develop a diabetes management and 504 plan, to assist in overcoming common social determinant disruptors faced by children with T1D and their families.

Given that historically, funding for school nurses and access to telehealth services is less likely in poor and rural communities as funding is tax based, our group proposes that federal policy is supported to ensure a comprehensive healthcare delivery model which integrates families, providers, and school nurses into the care plan and management. This would require advocating for a restructured federal reimbursement program which will enable healthcare funding streams to reimburse school nursing services that may otherwise be covered in other healthcare settings, including telehealth visits.