Technology Utilization in Black Adolescents with Type 1 Diabetes: Exploring the Decision-Making Process.
Technology Utilization in Black Adolescents with Type 1 Diabetes: Exploring the Decision-Making Process.
复制标题
患有 1 型糖尿病的黑人青少年的技术利用：探索决策过程。
DOI：
10.1089/dia.2021.0413
复制
发表时间：
2022
影响因子：
5.4
通讯作者：
Sadler,LoisS
中科院分区：
文献类型：
--
作者：
Mencher,ShanaR;Weinzimer,StuartA;Nally,LauraM;VanName,Michelle;Nunez-Smith,Marcella;Sadler,LoisS
背景：黑人青少年1型糖尿病（T1D）患者糖尿病装置（DD）的使用存在显著差异，值得进一步探讨。我们试图描述患有T1D的黑人青少年及其父母如何决定使用DDs，并了解可能影响使用的个人、家庭和文化信仰。材料与方法：19名患有T1D的黑人青少年和17名父母参加了个体定性半结构化访谈。有针对性地对青少年进行了一系列社会经济和临床人口统计学抽样。访谈数据被记录、转录和编码，用于主题分析，分别对父母和青少年进行分析，然后跨组进行比较。数据收集一直持续到专题饱和为止。结果：青少年和父母报告了与(1)多重身份的交叉性相关的相似主题：黑人青少年的T1D经历；(2)决定使用dd：增加T1D管理的复杂性，减轻负担；(3)黑人青少年ddds摄取差异的原因。青少年报告说，缺乏与T1D“长得像我”的同伴，这导致了耻辱，而设备的可见性和警报加剧了这种耻辱。文化和家庭传统以及个人因素被描述为DD使用的促进因素和障碍。缺乏对T1D的熟悉，对DD的接触有限，以及对医学界的不信任，无论是过去还是现在，都被认为是DD使用不公平的原因。结论：了解一个黑人青少年及其父母样本中围绕DD的决策过程对于指导进一步研究以提高DD使用和血糖结局的公平性至关重要。
Background:Significant disparities in diabetes device (DD) use exist for Black adolescents with type 1 diabetes (T1D), meriting further exploration. We sought to describe how Black adolescents with T1D and their parents make decisions about using DDs and understand personal, familial, and cultural beliefs that may influence use.Materials and Methods:Nineteen Black adolescents with T1D and 17 parents participated in individual qualitative semistructured interviews. Adolescents were purposively sampled for a range of socioeconomic and clinical demographics. Interview data were recorded, transcribed, and coded for thematic analysis, analyzed separately for parents and adolescents, and then compared across groups. Data collection continued until thematic saturation was achieved.Results:Adolescents and parents reported similar themes related to the (1) intersectionality of multiple identities: T1D experience of Black adolescents; (2) decision to use DDs: complexities of T1D management and easing the burden; and (3) reasons for differential uptake of DDs in Black adolescents. Adolescents reported lacking peers with T1D “who look like me,” leading to stigmatization, exacerbated by device visibility and alarms. Cultural and familial traditions as well as individual factors were described as both facilitators and barriers in DD use. Lack of familiarity with T1D, limited exposure to DDs, and mistrust of the medical community, both historically and currently, were brought up as reasons for inequities in DD use.Conclusions:Understanding the decision-making process surrounding DDs in one sample of Black adolescents and their parents is critical to guide further research to improve equity in DD use and glycemic outcomes.