Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas.
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
Sci Diabetes Self Manag Care. 2023 Feb;49(1):55-64. doi: 10.1177/26350106221145323. Epub 2023 Jan 6.
The purpose of the study was to describe differences in non-Hispanic Black (NHB) and non-Hispanic White (NHW) parents' perceptions of factors that influence the use of diabetes technology.
Focus groups were conducted with parents of NHB and NHW children at a pediatric diabetes center in the Northeast United States. Kilbourne's health disparities framework informed the focus group guide and a priori coding for directed content analysis. Further analysis allowed subcategories to emerge inductively.
Twenty-one parents participated. Five subcategories emerged, describing differences in NHB and NHW parent decisions regarding diabetes technology: (1) child's choice, (2) shame versus pride, (3) pros and cons of technology, (4) time frame, and (5) blood glucose indications of readiness. NHB parents feared technology malfunction, worried that visible devices could worsen experienced stigma of diabetes diagnosis, and described the diabetes team as gatekeepers, who changed eligibility criteria for diabetes technology use for their research purposes. In contrast, NHW parents reported diabetes team expectation of diabetes technology use and did not report provider-related barriers.
This study adds to existing literature advancing our understanding of the patient and provider mechanisms underlying racial disparities in diabetes technology use. This understanding may guide development of interventions focused on patients, providers, and structural factors to improve equity in use of diabetes technology by youth with type 1 diabetes.
本研究旨在描述非西班牙裔黑人和非西班牙裔白人（NHW）父母对影响糖尿病技术使用的因素的看法的差异。
在东北部的一家儿科糖尿病中心，对非西班牙裔黑人（NHB）和非西班牙裔白人（NHW）儿童的父母进行了焦点小组讨论。Kilbourne 的健康差异框架为焦点小组指南和定向内容分析的先验编码提供了信息。进一步的分析允许归纳出亚类别。
21 名家长参与。描述了非西班牙裔黑人和非西班牙裔白人父母在决定使用糖尿病技术方面的差异的五个亚类别：（1）孩子的选择，（2）羞耻与自豪，（3）技术的利弊，（4）时间框架，以及（5）血糖准备就绪的迹象。非西班牙裔黑人父母担心技术故障，担心可见的设备可能会加剧对糖尿病诊断的耻辱感，并且将糖尿病团队描述为守门人，他们为了研究目的改变了使用糖尿病技术的资格标准。相比之下，NHW 父母报告说糖尿病团队期望使用糖尿病技术，并且没有报告与提供者相关的障碍。
本研究增加了现有的文献，进一步了解了糖尿病技术使用中种族差异的患者和提供者机制。这种理解可能会指导针对患者、提供者和结构因素的干预措施的制定，以改善 1 型糖尿病青少年对糖尿病技术使用的公平性。
