College of Psychology, Department of Clinical & School Psychology, Nova Southeastern University, USA.
Salah Foundation Children's Hospital, Broward Health Medical Center, USA.
J Pediatr Psychol. 2023 Jan 12;48(1):17-28. doi: 10.1093/jpepsy/jsac070.
This study examined caregiver perceived impact of the Coronavirus Disease 2019 (COVID-19) pandemic on a diverse sample of U.S. youth with diabetes and their families.
Caregivers of youth with diabetes completed an electronic survey in English or Spanish at two sites. Participants provided demographic and disease characteristics and completed the COVID-19 Exposure and Family Impact Scales (CEFIS). Glycemic health was assessed via Hemoglobin A1c (HbA1c) from medical chart review. Analysis of variance and analyses of covariance were utilized to examine racial/ethnic differences in glycemic health and in COVID-19 Exposure, Impact, and Distress scales. Hierarchical linear regression was conducted to predict HbA1c. Thematic analysis was conducted on open-ended responses regarding the effects of COVID-19 on youth and families' overall and diabetes-related well-being.
Caregivers (n = 114) of youth with diabetes (M = 12.6 ± 3.5 years) completed study measures. Mean HbA1c for Non-Hispanic White youth was lowest and significantly different from Hispanic and Non-Hispanic Black youth. Exposure to COVID-19 stressors differed by race/ethnicity (p < .05) with Hispanic caregivers reporting greatest exposure. CEFIS scales did not predict HbA1c after controlling for demographic/disease variables. Caregivers described child/family changes during COVID (e.g., more time together, health-related hypervigilance), as well as differences in diabetes management during COVID-19.
Findings indicate differences in COVID-19 exposure but did not demonstrate other racial/ethnic disparities in COVID-19 impact or distress. Household income was the most important predictor of glycemic health. Addressing structural inequalities experienced by youth with diabetes and their families is critical. Recommendations to support families with diabetes are made.
本研究考察了新冠疫情对美国不同种族裔青少年及其家庭中糖尿病患者的影响。
糖尿病患儿的照顾者通过英文或西班牙语在两个地点完成电子调查。参与者提供了人口统计学和疾病特征，并完成了新冠暴露和家庭影响量表（CEFIS）。通过查看病历，用糖化血红蛋白（HbA1c）评估血糖控制情况。利用方差分析和协方差分析，检验了不同种族裔在血糖控制和新冠暴露、影响和困扰量表方面的差异。采用分层线性回归预测 HbA1c。对关于新冠疫情对青少年和家庭整体及糖尿病相关健康的影响的开放式问题进行主题分析。
共有 114 名糖尿病患儿的照顾者（平均年龄 12.6±3.5 岁）完成了研究评估。非西班牙裔白种人患儿的平均 HbA1c 最低，与西班牙裔和非西班牙裔黑种人患儿显著不同。新冠疫情压力源的暴露程度因种族/民族而异（p<.05），西班牙裔照顾者的暴露程度最高。在控制了人口统计学/疾病变量后，CEFIS 量表并不能预测 HbA1c。照顾者描述了新冠疫情期间儿童/家庭的变化（例如，更多的相处时间，对健康问题的高度警惕），以及新冠疫情期间糖尿病管理方面的差异。
研究结果表明，新冠疫情的暴露程度存在差异，但在新冠疫情的影响或困扰方面没有表现出其他种族/民族差异。家庭收入是血糖控制的最重要预测因素。解决糖尿病患儿及其家庭面临的结构性不平等问题至关重要。为支持糖尿病家庭提出了建议。
