1422-P: Understanding COVID-19 Impacts among Underserved Adults with Diabetes Using the Social-Ecological Model

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Introduction & Objective: People with diabetes reported disparate health, psychosocial, and financial outcomes from COVID-19. This study aimed to understand experiences of underserved adults with diabetes during the COVID-19 pandemic. Methods: A survey assessing COVID-19 impacts was administered to adults with insulin-requiring diabetes (n=450) at federally qualified health centers in CA and FL between Nov. 2021-Jul. 2022. This qualitative study analyzed responses to an open-ended question asking patients to describe the pandemic’s impact on their lives (n=263, mean age=53.5 ± 14.3 years, 60.5% T2D). Responses were coded via a thematic analysis guided by CDC’s Social-Ecological Model (SEM), which asserts that health occurs at and is affected by 4 levels: Individual, Relationship, Community, and Societal. Descriptive statistics (n, %) determined the frequency of impacts reported; some patients noted multiple impacts. Results: A total of 546 codes were identified; 490 reported COVID-19 impacts (89.7%); 56 noted no impact (10.3%). Among reported impacts, most were Individual-level (n=208, 42.5%), e.g., diagnoses of COVID-19 or other illnesses, mental health issues, higher blood glucose, and weight gain. Societal impacts (n=158, 32.2%) included concerns regarding COVID-19 information, income loss, and challenges scheduling medical appointments, ordering diabetes supplies, and accessing healthy foods. Relationship impacts (n=65, 13.3%) included social isolation and reduced family/peer interactions. Community impacts (n=44, 9.0%) included occupational changes, extra precautions in high-risk areas, and challenges with local transportation and housing. The remainder were unspecific (n=15, 3.1%). Conclusion: COVID-19 impacts among underserved adults with diabetes stem from factors across the SEM. Multi-level interventions are needed to improve patients’ healthcare, promote social support, enhance local preventive efforts, and reduce inequities. Disclosure J. Maizel: None. R. Attanti: None. K. Chennuri: None. R. Smith: None. S.L. Filipp: None. M. Hechavarria: None. M.J. Haller: Consultant; Sanofi. Advisory Panel; SAB Biotherapeutics, Inc. Consultant; MannKind Corporation. S. Westen: None. B. Dixon: None. D.M. Maahs: Advisory Panel; Medtronic. Consultant; Abbott, LifeScan Diabetes Institute, Sanofi, Provention Bio, Inc., Bayer Inc., Kriya Therapeutics, BioSpex. R. Lal: Consultant; Abbott, Adaptyx Biosciences, Biolinq, Capillary Biomedical, Inc., Deep Valley Labs, Gluroo, PhysioLogic Devices, Portal Insulin, Tidepool. Advisory Panel; Lilly Diabetes. A. Addala: None. A.F. Walker: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust (G-2005-03934)

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