Racial Disparities in Technology Use in Children With Type 1 Diabetes: A Qualitative Content Analysis of Parents'...

Area of Science:

• Health disparities research
• Pediatric endocrinology
• Behavioral science

Background:

• Racial disparities in type 1 diabetes management are well-documented.
• Understanding parental perceptions is crucial for addressing these disparities.
• Diabetes technology use is a key area where inequities manifest.

Purpose of the Study:

• To explore and describe differences in perceptions between non-Hispanic Black (NHB) and non-Hispanic White (NHW) parents regarding factors influencing diabetes technology adoption.
• To identify specific patient and provider mechanisms contributing to racial disparities in technology use among youth with type 1 diabetes.

Main Methods:

• Qualitative study employing focus groups with parents of NHB and NHW children diagnosed with type 1 diabetes.
• Utilized Kilbourne's health disparities framework to guide data collection and initial analysis.
• Employed directed content analysis with inductive subcategory emergence for in-depth understanding.

Main Results:

• Five key subcategories emerged: child's choice, shame vs. pride, technology pros/cons, time frame, and blood glucose readiness indicators.
• NHB parents expressed concerns about technology malfunction, stigma associated with visible devices, and perceived gatekeeping by the diabetes team regarding technology access.
• NHW parents reported expectations of technology use from the diabetes team and did not identify similar provider-related barriers.

Conclusions:

• Findings illuminate patient and provider mechanisms contributing to racial disparities in diabetes technology use.
• Results underscore the need for interventions targeting patients, providers, and structural factors to promote equitable technology adoption.
• This research can inform strategies to improve type 1 diabetes management equity for all youth.