Abstract

Only 29% of African-Americans and 39% of Latinx persons living with type 1 diabetes mellitus (T1DM) use insulin pumps, compared with 61% of white individuals. Social determinants of health contribute to suboptimal access to and use of DM devices. We applied a design thinking process to better understand these barriers, and created a publication that both persons living with DM (PWD) and health care professionals (HCP) could use to provide information and spark a dialogue on DM devices and management. The Double Diamond Process is a human-centered design framework that discovers, then defines a problem, to develop and deliver a prototype. After diversity, equity, and inclusion training with a consultancy, we interviewed 6 PWD, and 4 HCP (1 dietitian, 1 psychologist, and 2 physicians). We identified 3 key challenges: PWD feel that their contexts, experiences, and needs are often not well-represented or addressed by DM information resources; HCP may not discuss devices; and PWD may not feel fully seen or heard during clinic visits. User testing helped refine a low-fidelity prototype for an online and print publication, Humans of Diabetes (HOD), with two checklists. The first guides the PWD and HCP through key topics to discuss during clinic visits. The second invites the PWD to reflect on the interaction with the HCP. Both checklists increase PWD's and HCP's awareness of implicit bias and suggest talking points. Compiled with help from advocates of color in the DM communities, HOD features images and stories of people of color living well with DM; as well as resources on DM, devices, medications, and community support. PWD can easily tear off and keep the print version's checklists. HOD could be distributed widely in primary care and DM clinics. HOD grew out of the design thinking process. This patient-centered collaboration with individuals from diverse perspectives could better start and enhance important conversations, to further optimize access and engagement with devices and care. Disclosure E.C.Chao: None. H.Rataj: None. D.J.Pai: None. H.Nagra: Employee; One Drop.

Full Text
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