585-P: African-American Youth and Parent Perspectives on Advanced Technologies in Diabetes Management: Closing the Loop on Health Disparities

Abstract

Background: Research has shown that African American (AA) youth with type 1 diabetes (T1D) are at increased risk for suboptimal glycemic control, and less often utilize advanced technologies for diabetes management (DM) . Objective: To better understand challenges to optimal DM for AA youth and willingness to use advanced technologies. Methods: Twenty-one AA youth with T1D and their parents participated in multi-family focus groups or individual family semi-structured interviews addressing barriers to DM and attitudes about new technologies such as the advanced hybrid closed loop (AHCL) insulin pump. Groups and interviews were recorded and conducted either in-person or using telehealth methods. Based on verbatim transcripts, content analysis was conducted using NVivo to develop a code book; two independent raters coded responses into themes and a third rater resolved discrepancies. Results: The 21 youth participants (8 girls and 13 boys) had a mean age of 14.0 years and mean HbA1c of 9.6%; 16 (76%) had Medicaid; (47.6%) were using CGM and six (28.5%) had insulin pumps. Qualitative analyses revealed six main themes encompassing current regimens, life with diabetes, parenting, ethnicity, willingness to try new DM technologies, and hesitancy to utilize an AHCL system. Thirteen (62%) youth-parent dyads reported being very willing to try the AHCL system while just two (9.5%) reported they preferred to stay with their current regimen of injections and blood glucose checks; six dyads (28.5%) were open but not ready to commit, citing concerns about reliance on technology, potential side effects, and need for more information. Conclusions: Innovative technology such as the AHCL insulin pump system may help to improve glycemic outcomes and reduce health disparities for AA youth. Many AA youth with T1D and their parents are ready to try advanced technologies but may require individualized support from the health care team to achieve optimal outcomes. Disclosure A.M.Delamater: None. E.R.Pulgaron: None. G.Guevara: None. S.A.Washington: None. D.Z.Franz: None. R.Gomez: None. D.Felipe: None. J.Bhat: None. S.Chalew: Advisory Panel; Medtronic. Funding National Institutes of Health (1R21DK118643)