By Kat Procyk
A school nurse checks a student’s glucose monitor, a common practice during the school day.
During math class, a fifth grader’s glucose monitor sends an alert triggered by a drop in blood sugar. The student heads to the school nurse’s office for treatment. Inevitably, the student misses the remainder of the lesson as well as an explanation of the homework due the following morning.
It’s one of the dozens of diabetes-related decisions made during the school day—decisions that can affect not only children’s learning, but also their long-term health. Despite advancements in care, many children with Type 1 diabetes still struggle to meet their glycemic targets.
Christine March, assistant professor of pediatrics, School of Medicine, University of Pittsburgh, is leading a pilot trial to determine whether closer coordination among parents, school nurses and diabetes specialists can help children better manage the condition where they spend a good part of their day: in school. The trial uses the School-Partnered Collaborative Care (SPACE) model, adapted from an evidence-based, integrated health care approach primarily used to treat behavioral health conditions in primary care settings, the Collaborative Care Model. SPACE uses reoccurring virtual meetings to connect all members of the child’s care team where they collaborate on shared treatment plans, optimize daily diabetes management and improve health outcomes.
"The communication that's happening between the school, the family and the health care team is often siloed,” March says. “Our goal is to bring the school health team and the diabetes medical team together so they can work more seamlessly to support the child.”
Eleven school districts—rural, suburban and urban—in western Pennsylvania and 30 of their students are participating. Based on the trial’s early success, researchers expect to expand the program into approximately 30 school districts across Allegheny, Westmoreland and Erie counties, where researchers will evaluate its impact on both health and academic outcomes while strengthening the evidence for school-based interventions supporting youth with chronic diseases.
“Schools are such a critical part of care for children with chronic illness,” March says. “We see real potential for this model to be adapted beyond Type 1 diabetes to other conditions where coordination between school nurses, families and clinicians can make a meaningful difference.”