Barriers to Technology Use and Endocrinology Care for Underserved Communities With Type 1 Diabetes
| Autor: | Gina Aulisio, Sarah C. Westen, Brian C. Fitzgerald, Claudia Anez-Zabala, Jason Konopack, Stephanie L. Filipp, Xanadu Roque, Ananta Addala, Korey K. Hood, Katarina Yabut, David M. Maahs, Diana Naranjo, Jennifer Maizel, Elvira Mercado, Nicolas Cuttriss, Sydney Look, Matthew J. Gurka, Ashby F. Walker, Michael J. Haller |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Research design
Adult Blood Glucose medicine.medical_specialty Technology Diabetic ketoacidosis Adolescent Endocrinology Diabetes and Metabolism Psychological intervention Ethnic group Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Humans Socioeconomic status Advanced and Specialized Nursing Type 1 diabetes business.industry Blood Glucose Self-Monitoring Clinical Care/Education/Nutrition/Psychosocial Research Middle Aged medicine.disease Focus group Diabetes Mellitus Type 1 business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE Disparities in type 1 diabetes related to use of technologies like continuous glucose monitors (CGMs) and utilization of diabetes care are pronounced based on socioeconomic status (SES), race, and ethnicity. However, systematic reports of perspectives from patients in vulnerable communities regarding barriers are limited. RESEARCH DESIGN AND METHODS To better understand barriers, focus groups were conducted in Florida and California with adults ≥18 years old with type 1 diabetes with selection criteria including hospitalization for diabetic ketoacidosis, HbA1c >9%, and/or receiving care at a Federally Qualified Health Center. Sixteen focus groups were conducted in English or Spanish with 86 adults (mean age 42 ± 16.2 years). Transcript themes and pre–focus group demographic survey data were analyzed. In order of frequency, barriers to diabetes technology and endocrinology care included 1) provider level (negative provider encounters), 2) system level (financial coverage), and 3) individual level (preferences). RESULTS Over 50% of participants had not seen an endocrinologist in the past year or were only seen once including during hospital visits. In Florida, there was less technology use overall (38% used CGMs in FL and 63% in CA; 43% used pumps in FL and 69% in CA) and significant differences in pump use by SES (P = 0.02 in FL; P = 0.08 in CA) and race/ethnicity (P = 0.01 in FL; P = 0.80 in CA). In California, there were significant differences in CGM use by race/ethnicity (P = 0.05 in CA; P = 0.56 in FL) and education level (P = 0.02 in CA; P = 0.90 in FL). CONCLUSIONS These findings provide novel insights into the experiences of vulnerable communities and demonstrate the need for multilevel interventions aimed at offsetting disparities in diabetes. |
| Databáze: | OpenAIRE |
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