Status:

RECRUITING

Addressing Social Needs to Improve Health in Adults With Multiple Chronic Conditions

Lead Sponsor:

Kaiser Permanente

Conditions:

Multiple Chronic Conditions

Social Needs

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

The investigators will conduct a comparative effectiveness randomized clinical trial with two "active comparator" arms. The investigators will evaluate the two current, usual care strategies (higher i...

Detailed Description

The goal of the proposed research is to compare the effectiveness of two strategies for addressing social needs in a large, high-risk population of adults with multiple chronic conditions (MCC). Spec...

Eligibility Criteria

Inclusion

  • Two or more chronic medical conditions from a defined list of 24 chronic conditions
  • One or more gaps in evidence-based care (related to condition-specific risk factor management, evidence-based screening and preventive care, missed appointments, and medication non-adherence),
  • At least one self-reported social-related barrier to care or "social need" (e.g., transportation, food, housing, utilities, and/or financial insecurity).

Exclusion

  • major cognitive barriers (dementia, psychosis).
  • multiple prior year hospitalizations ("extremely high utilizers")

Key Trial Info

Start Date :

September 1 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

December 1 2029

Estimated Enrollment :

800 Patients enrolled

Trial Details

Trial ID

NCT06941519

Start Date

September 1 2025

End Date

December 1 2029

Last Update

December 8 2025

Active Locations (1)

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Division of Research

Pleasanton, California, United States, 94588