School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
J Diabetes. 2019 Jul;11(7):582-592. doi: 10.1111/1753-0407.12889. Epub 2019 Jan 24.
The increasing incidence of type 1 diabetes (T1D) in youth aged less than 20 years in the USA is a mounting public health concern. Specific sociodemographic characteristics-racial/ethnic minority, low socioeconomic status (SES), single-parent home and underinsured-have been associated with increased risk for poor glycemic control and poor self-management in adolescents with T1D.
Sample demographic and cultural responsiveness methods in psychosocial and behavioral interventions focused on improving self-management and glycemic control in adolescents with T1D were systematically evaluated, to identify if studies were targeting these high-risk groups. Keyword searches of PsychInfo, PubMed and CINAHL identified 259 studies published between 2006 and 2016, of adolescents (13-18 years old) with T1D; 28 studies met inclusion criteria.
Samples focused predominantly on White adolescents with fair glycemic control, from middle-high income, two-parent households with private insurance. The majority of studies scored poorly in cultural responsiveness and moderately in culturally responsive reporting. Studies lacked descriptions of culturally inclusive recruitment and sampling methods, and use of culturally responsive assessments for diverse groups. The majority of studies recruited and enrolled homogeneous adolescent samples from the lowest risk groups.
T1D intervention researchers must increase targeted recruitment and sampling methods to include more high-risk pediatric T1D groups, expand sociodemographic reporting, and increase the use of culturally responsive recruitment and sampling methods, such as those used in community-based participatory research. Such efforts have the potential to reduce T1D disparities by making interventions more relevant to the unique needs, goals and priorities of highest risk groups.
美国 20 岁以下青少年 1 型糖尿病（T1D）发病率不断上升，这是一个日益严重的公共卫生问题。特定的社会人口学特征——少数民族、低社会经济地位（SES）、单亲家庭和保险不足——与青少年 T1D 患者血糖控制不良和自我管理不善的风险增加有关。
系统评估了专注于改善青少年 T1D 自我管理和血糖控制的心理社会和行为干预措施中的样本人口统计学和文化响应方法，以确定研究是否针对这些高风险群体。在 PsychInfo、PubMed 和 CINAHL 上进行关键字搜索，确定了 2006 年至 2016 年间发表的 259 项针对青少年（13-18 岁）T1D 的研究；其中 28 项研究符合纳入标准。
样本主要集中在血糖控制良好的白种青少年，他们来自中高收入、有私人保险的双亲家庭。大多数研究在文化反应性方面得分较低，在文化反应性报告方面得分中等。研究缺乏关于文化包容性招募和抽样方法的描述，也没有针对不同群体使用文化反应性评估。大多数研究招募和纳入了来自风险最低群体的同质青少年样本。
T1D 干预研究人员必须增加有针对性的招募和抽样方法，以包括更多高风险的儿科 T1D 群体，扩大社会人口统计学报告，并增加使用文化反应性的招募和抽样方法，例如社区参与性研究中使用的方法。通过使干预措施更符合最高风险群体的独特需求、目标和优先事项，这些努力有可能减少 T1D 差异。
