1293-P: Efficiency of Screening for Type 1 Diabetes and Celiac Disease in Various Health Care Settings: Autoimmunity Screening for Kids (ASK)

Our goal was to explore feasibility of screening for pre-symptomatic type 1 diabetes (T1D) and celiac disease (CD) in the general population. Efficiency of and barriers to sustainable screening in various health care settings are described. From 2017-2019, the ASK study screened 23,578 children in Colorado. Of those, 0.94% were positive for islet (95% CI 0.82-1.08) and 2.10% for transglutaminase (95% CI 1.92-2.29) autoantibodies. The screening aimed to engage providers in hospital specialty clinics (HSC), emergency departments (ED), private primary care (PPC), government primary care (GPC), diabetes center (BDC), community events (CE), and retail clinics (RC). ASK provided, as needed, on-site screening staff, provider reimbursement, and electronic consenting. Efficiency was defined as #screened/research staff full-time effort per week. The majority (72%) of screenings were completed at an ED or HSC, with 91% of screenings conducted by ASK staff. Highest screening efficiency was in the ED (Figure 1). While efficient, RC yielded small numbers. Challenges to screening program implementation included inconsistent provider time and commitment, limited clinic space, competing priorities, and research constraints. Translation to a sustainable screening in primary care will need to address these challenges in a practice-specific fashion. Disclosure C.R. Geno Rasmussen: None. K. Waugh: None. J. Baxter: None. A. Steck: None. B.I. Frohnert: None. M. Rewers: None. Funding JDRF (3-SRA-2018-564-M-N)