2099-P: Primary Care Pediatrician (PCP) Priorities for Implementation of Type 1 Diabetes (T1D) Screening in Youth at Risk

Introduction and Objective: PCP uptake of screening for T1D antibodies in those with a family history is recommended yet remains uncommon. Implementation science (IS) can help select and test strategies to promote screening in primary care. We conducted a pre-implementation assessment with PCPs to prioritize strategies for screening. Methods: We led site visits at 4 geographically diverse PCP offices (n=29 providers) in Western Pennsylvania. Providers participated in a facilitated discussion about facilitators/barriers to screening followed by a survey to rate IS strategies using a 1-5 Likert-type response (1=very unhelpful to 5=very helpful). Results: Facilitators included high perceived value of screening and similarities to existing screening practices in primary care. PCP concerns included (1) obtaining updated and accurate family history of T1D in well child care visits, (2) lack of resources to address positive screens, and (3) potential family costs/travel for screening/follow up care. Among 21 surveys, 5 strategies were highly prioritized with scores >4.5/5, focusing on electronic health record (EHR) templates, protocolized decision aids, and expert support (Table). Conclusion: Implementation trials should test the impact of combined strategies to promote uptake of T1D screening by PCPs, focusing on integrated clinical and EHR workflows and easy referral to pediatric endocrinology for staging/monitoring/interventions. Disclosure S. Orris: None. M. Ganoe: None. P.L. Schoemer: None. I. Libman: None. C. March: None. Funding UPMC Children's Hospital of Pittsburgh Foundation, Cochrane Weber Endowment