Shana R. Mencher, United States of America
Yale University Pediatric EndocrinologyPresenter of 1 Presentation
TECHNOLOGY UTILIZATION IN AFRICAN AMERICAN YOUTH WITH TYPE 1 DIABETES: EXPLORING THE DECISION MAKING PROCESS
Abstract
Background and Aims
Significant disparities in diabetes device (DD) use exist for African American (AA) adolescents with type 1 diabetes (T1D), meriting further exploration. We sought to describe how AA adolescents with T1D and their guardians make decisions about using DDs and to understand personal, familial and cultural beliefs that may influence use.
Methods
Nineteen AA adolescents with T1D and 17 guardians participated in individual qualitative semi-structured interviews. Adolescents were purposively sampled for a range in socioeconomic and clinical demographics. Interview data were recorded, transcribed, and coded for thematic analysis, analyzed separately for guardians and adolescents, and then compared across groups. Data collection continued until thematic saturation was achieved.
Results
Adolescents and guardians reported similar themes related to (1) intersectionality of age, race and T1D; (2) decisions about DDs; (3) insight about use/nonuse of DDs; and (4) advice about enhancing success with DDs. Adolescents reported lacking peers with T1D “who look like me,” leading to stigmatization, exacerbated by device visibility and alarms. Cultural and familial traditions were described as both facilitators and barriers in decisions about DDs. TID self-management support included extended family, school personnel and clinic providers. Lack of familiarity with T1D, limited exposure to DDs, and mistrust were reasons for decreased uptake of DDs. Participants provided specific suggestions for clinical support for use of DDs.
Conclusions
Understanding the decision-making process surrounding DDs and preferences around methods of education, peer support and follow-up may help to ameliorate some disparities in DD use, leading to improved glycemic control and outcomes.