Thomas Courtney, Ramirez Alejandra Perez, Alderfer Melissa A, Patton Susana R, Carakushansky Mauri, Enlow Paul T
Center for Healthcare Delivery Science, Nemours Children's Hospital, Delaware, Wilmington, DE.
Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.
Diabetes Spectr. 2023 Summer;36(3):245-252. doi: 10.2337/ds22-0053. Epub 2023 Feb 28.
At the outset of the coronavirus disease 2019 (COVID-19) pandemic, health care systems rapidly implemented telehealth services to maintain continuity of type 1 diabetes care. Youth of color are more likely to have suboptimal glycemic control and may benefit most from efforts to ensure continuity of care. However, research examining the perspectives of families of youth of color regarding telehealth for pediatric type 1 diabetes care is limited. We gathered perspectives from youth of color, their caregivers, and health care providers (HCPs) on telehealth for type 1 diabetes care during COVID-19.
Fifty participants (22 caregivers, 19 youth, and nine HCPs) completed semi-structured interviews conducted in English ( = 44) or Spanish ( = 6). Transcripts containing mentions of telehealth ( = 33) were included for qualitative analysis to extract themes pertaining to perceptions of type 1 diabetes care and telehealth use during COVID-19.
Themes related to perceptions, feasibility, and quality of telehealth diabetes care were obtained. Most families had positive perceptions of telehealth. Families and HCPs described logistical and technical challenges and noted the potential for disparities in telehealth access and use. Furthermore, caregivers and HCPs felt that the lack of in-person interaction and limited access to clinical data affected the quality of care.
Families of youth of color with type 1 diabetes mostly had positive perceptions of telehealth but also identified issues with feasibility and quality of care. Our findings highlight a need for interventions promoting equal access to telehealth and quality care for all youth with type 1 diabetes to minimize disruptions in care.
在2019年冠状病毒病（COVID-19）大流行初期，医疗保健系统迅速实施远程医疗服务，以维持1型糖尿病护理的连续性。有色人种青少年的血糖控制情况更有可能不理想，可能会从确保护理连续性的努力中获益最多。然而，关于有色人种青少年家庭对儿科1型糖尿病护理远程医疗的看法的研究有限。我们收集了有色人种青少年、他们的照顾者以及医疗保健提供者（HCPs）对COVID-19期间1型糖尿病护理远程医疗的看法。
50名参与者（22名照顾者、19名青少年和9名HCPs）完成了以英语（n = 44）或西班牙语（n = 6）进行的半结构化访谈。纳入包含远程医疗提及内容的访谈记录（n = 33）进行定性分析，以提取与COVID-19期间对1型糖尿病护理和远程医疗使用的看法相关的主题。
获得了与远程医疗糖尿病护理的看法、可行性和质量相关的主题。大多数家庭对远程医疗有积极的看法。家庭和HCPs描述了后勤和技术方面的挑战，并指出了远程医疗获取和使用方面存在差异的可能性。此外，照顾者和HCPs认为缺乏面对面互动以及获取临床数据有限影响了护理质量。
患有1型糖尿病的有色人种青少年家庭大多对远程医疗有积极看法，但也指出了可行性和护理质量方面的问题。我们的研究结果凸显了需要采取干预措施，促进所有1型糖尿病青少年平等获得远程医疗和高质量护理，以尽量减少护理中断。
