Pilot-Testing Strategies to Improve Outcomes for Youth With Type 2 Diabetes by Addressing Health-Related Social Needs

4-item Acceptability of Intervention Measure; completed by all adolescents and caregivers. Questions are specific to acceptability of the screening questionnaire used to assess health-related social needs, with responses ranging from completely disagree to completely agree (5-point scale). A mean of 4 or higher indicates acceptability.

4-item Acceptability of Intervention Measure; completed by adolescents and caregivers assigned to arms using a tailored approach (not universal empowerment). Questions are specific to acceptability of the tailored approach used to address health-related social needs, with responses ranging from completely disagree to completely agree (5-point scale). A mean of 4 or higher indicates acceptability.

4-item Acceptability of Intervention Measure; completed by adolescents and caregivers assigned to arms using a universal empowerment approach (not tailored approach). Questions are specific to acceptability of the universal empowerment approach used to address health-related social needs, with responses ranging from completely disagree to completely agree (5-point scale). A mean of 4 or higher indicates acceptability.

4-item Acceptability of Intervention Measure; completed by adolescents and caregivers assigned to arms using text messages without community health workers to support resource connection. Questions are specific to acceptability of the text messages without community health worker approach used to address health-related social needs, with responses ranging from completely disagree to completely agree (5-point scale). A mean of 4 or higher indicates acceptability.

4-item Acceptability of Intervention Measure; completed by adolescents and caregivers assigned to arms using text messages with community health workers to support resource connection. Questions are specific to acceptability of community health workers in addition to text messages to address health-related social needs, with responses ranging from completely disagree to completely agree (5-point scale). A mean of 4 or higher indicates acceptability.

Investigator developed survey around receipt of intervention components including resources requested and used, community health worker interactions, and text message receipt; completed by adolescents and caregivers in all arms. Frequency and types of resources used, as well as community organizations with which respondents interacted will be reported. Frequency and duration of contact with community health workers will be reported for those assigned to arms using community health workers.

Six-Item Standard Measure from USDA Economic Research Service; completed by adolescents and caregivers. Food insecurity assessment includes 5 questions assessing presence and frequency of experiences consistent with food insecurity; responses include "often," "sometimes," or "never" as well as "yes" and "no." "Often," "sometimes," or "never" are scored as 1, 2, and 3 respectively, with yes=1 and no=2. The sum of affirmative responses ("often," "sometimes," "yes") is the raw score, with 0-1 indicating high or marginal food security, 2-4 low food security, 5-6 very low food security. Percentage of positive responses (food insecurity: marginal, low, or very low food security) will be reported.

3 items from the PhenX repository; completed by adolescents and caregivers. Housing is assessed using 3 questions about living situation, stress related to rent/mortgage, and problems with housing; responses describing worry about losing a place to live or not having a steady place to live, as well as problems with housing, or always, usually, or sometimes worrying about not having enough money to pay rent or mortgage indicate positive housing insecurity. Percentage of positive responses (housing insecurity) will be reported.

1 item from the PhenX repository; completed by adolescents and caregivers to assess lack of reliable transportation for medical appointments (yes/no). Percentage of affirmative responses (transportation insecurity) will be reported.

As measured during clinic visit; for adolescents only. Reported as %.

As measured at clinic visits; for adolescents only. Reported as kg/m2.

PACE questionnaire is a 2-item survey to evaluate frequency of engagement in at least 60 minutes of daily physical activity over the past 7 days and a typical week. Higher numbers of days indicates greater adherence to physical activity guidelines for adolescents. Administered to adolescent participants only.

BRIEF Health Literacy Survey is a 4-item questionnaire with 5 response options each ranging from "not at all" to "extremely." Responses are totaled for a possible score of 4-20, with higher scores corresponding to higher health literacy.

The Mood and Feelings Questionnaire: Short Version will be used to evaluate mood in adolescent and caregiver participants. This 13-item survey includes responses of "not true", "sometimes", and "true", scored as 0, 1, and 2. Total scores range from 0-26, with higher scores indicating higher severity.

Multidimensional Scale of Perceived Support Scale (Zimet, Dahlem, Zimet, Farley, 1988); completed by adolescents and caregivers. The 12-item survey includes a 7-item scale of response from "very strongly disagree" (1) to "very strongly agree" (7). There are 3 subscales to indicate significant other, family, and friends support. Responses will be averaged by subscale, with higher numbers indicating greater support. A total score (average of 12 response) will be reported.

Investigator-developed survey around hours of connection with CHW, activities conducted with CHW, and resource connections made through CHW; completed by adolescents and caregivers assigned to CHW

Rapid Prime Diet Quality Screener, a 13-item survey to quantify frequency of intake of each food category. Scores range from 0-26, with higher scores indicating higher-quality diet.

Problem Areas in Diabetes Scale; completed by adolescents only. The 5-item scale includes a range of 5 responses, from "not a problem" (=0) to "serious problem" (=4). A total score of >=8 indicates possible diabetes related emotional distress.

Investigator-developed survey of doses of diabetes medication missed; completed by adolescents only. Questions include the number of days that daily diabetes medications were taken in the past 7 days, as well as number of times in the past 4 weeks that weekly diabetes medications were taken. Respondents will be categorized into fully adherent if they report taking daily medications 6-7 days out of the past 7 days and weekly medications at least 3 out of 4 past weeks; for those taking both daily and weekly, both daily and weekly medication adherence criteria must be met for fully adherent classification. Those not "fully adherent" will be categorized as non-adherent.

Adapted version of Trust in Physician Scale (adapted from Merenstein Z, Shuemaker JC, Phillips RL 2023) to add one question about trust in social workers. This 12-item scale includes response options ranging from "strongly disagree" to "strongly agree", with items indicating mistrust reverse scored. Total and average scores will be reported, with higher scores indicating greater trust.