Technology Utilization in Black Adolescents with Type 1 Diabetes: Exploring the Decision-Making Process

Area of Science:

• Endocrinology and Metabolism
• Adolescent Health
• Health Disparities

Background:

• Significant disparities exist in diabetes device (DD) use among Black adolescents with type 1 diabetes (T1D).
• Understanding the factors influencing DD adoption in this population is crucial for improving health outcomes.

Purpose of the Study:

• To explore the decision-making processes of Black adolescents with T1D and their parents regarding DD use.
• To identify personal, familial, and cultural beliefs impacting DD adoption among Black adolescents with T1D.

Main Methods:

• Qualitative study involving 19 Black adolescents with T1D and 17 parents.
• Individual, semistructured interviews were conducted and analyzed thematically.
• Data were collected until thematic saturation was achieved.

Main Results:

• Themes included the intersection of identity and T1D, the complexities of DD decision-making, and reasons for differential uptake.
• Adolescents reported stigma due to lack of relatable peers, device visibility, and alarms.
• Cultural traditions, familial factors, medical mistrust, and lack of familiarity with T1D were identified as barriers and facilitators.

Conclusions:

• Decision-making regarding DDs is influenced by a complex interplay of individual, familial, and cultural factors.
• Addressing stigma, building trust, and increasing familiarity with T1D and DDs are essential for improving equity.
• Further research is needed to guide interventions aimed at enhancing DD use and glycemic outcomes in Black adolescents with T1D.