RecruitingNot ApplicableNCT06903897

Social Needs Screening and Chronic Diseases Study (WE CARE)

Improving Chronic Disease Outcomes Across the Lifespan by Addressing Structural Racism


Sponsor

University of Massachusetts, Worcester

Enrollment

68,000 participants

Start Date

Oct 8, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

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

Plain Language Summary

Simplified for easier understanding

This trial is studying whether routinely screening patients for social needs (like food insecurity, housing problems, or financial stress) helps improve health outcomes for people with chronic diseases like diabetes, high blood pressure, high cholesterol, asthma, or depression. You may be eligible if: you are an adult (18+) with one of those diagnosed chronic conditions and you get your care at a participating Family Medicine clinic; or you are a child under 18 with a diagnosis of asthma. You may NOT be eligible if: you are an adult without any of the listed chronic condition diagnoses on file; or you are a child without an asthma diagnosis. Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERWE CARE SDOH System

The WE CARE System: A family-centered, highly efficacious approach for addressing adverse SDOH in the clinical setting. Arvin Garg, MD, MPH developed and conceptualized the WE CARE (Well-Child care visit, Evaluation, Community Resources, Advocacy, Referral, Education) intervention in 2005. This approach relies on existing clinical processes and infrastructure and social service resources, thereby making implementation, dissemination, and sustainability feasible. The intervention components include brief training of the clinical team; administration of a short screening tool to parents/patients identifying their desire for help with specific unmet social needs; and provider/clinic staff access to a physical or electronic family resource book containing community- resource listings. Providers generate referrals for families who indicate that they want help with unmet social needs on the WE CARE screener. Existing staff members may assist patients in connecting to referred resources.

OTHERStandard Pediatric Care

Standard pediatric care includes any existing screening practices, which can vary at each clinic.


Locations(3)

(Benedict) UMass Memorial Medical Center - Adult Primary Care

Worcester, Massachusetts, United States

UMass Memorial Medical Center - Hahnemann Campus

Worcester, Massachusetts, United States

Family Health Center of Worcester

Worcester, Massachusetts, United States

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NCT06903897


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