817-P: Financial Stress Factors, Psychological Factors, and Self-Management Outcomes in Emerging Adults with Type 1 Diabetes

Emerging adults, ages 18-25, with type 1 diabetes (T1D) may be vulnerable to financial and psychological barriers to self-management as they grapple with the developmental milestones of financial and self-management independence. This correlational, cross-sectional study described the relationships among financial stress factors (perceived stress, financial stress, and financial independence) and psychological factors (depressive symptoms, trait anxiety, and diabetes distress) on self-management outcomes (HbA1c and diabetes-related quality of life [DQoL]) in emerging adults with T1D. Data from 413 emerging adults recruited from the T1D Exchange (mean age 22.1±1.83 years; 62% female; 80.4% white; 37.3% private high-deductible insurance; T1D duration 13.2±4.41 years; 8.0±1.6 HbA1c) were analyzed. The Perceived Stress Scale, Personal Financial Well-Being Scale, Willingness to Pay Scale, Financial Independence Visual Analog Scale, Center for Epidemiological Studies-Depression Inventory, State-Trait Anxiety Inventory, Diabetes Distress Scale and DQoL Measure were completed via REDCap surveys. Hierarchical Multiple Regression analyses revealed that 20.6% of variance in HbA1c (F=15.555, p<.001) was explained by greater financial stress (β=-.197, p<.001) and diabetes distress (β=.181, p<.001); 64.5% of the variance in DQoL (F=148.469, p<.001) was explained by greater financial stress (β=-.112, p = .002), diabetes distress (β=.512, p<.001), trait anxiety (β=.183, p=.001) and depressive symptoms (β=.162, p=.001). Greater financial stress and psychological factors have detrimental impacts on self-management outcomes during emerging adulthood. Future interventions should assess and address these self-management barriers in practice.