Background: YA with T1D of non-Hispanic Black and Hispanic race-ethnicity face unique challenges to diabetes self-management, yet little research acknowledges potentially distinct lived experiences and needs between these racial/ethnic groups.
Methods: We recruited Black and Hispanic YA with T1D from adult and pediatric diabetes centers at Montefiore Medical Center in the Bronx, NY to conduct individual semi-structured interviews focusing on barriers and facilitators to diabetes self-management. Interviews were performed telephonically or in person, and recorded and transcribed. A modified inductive coding approach was used to analyze the data for common themes until thematic saturation was achieved.
Results: We interviewed 39 YA with T1D (18-25 yrs, 26% Black, 74% Hispanic, mean HbA1c 10.3%). Common T1D self-management barriers between Black and Hispanic YA centered on normative development, including competing priorities and peer acceptance of T1D. Differences in self-management barriers were related to culture and lived experience. Black YA reported major challenges related to social determinants of health, such as food insecurity, insurance lapses, and racial bias in the healthcare system. Meanwhile, Hispanic YA reported challenges related to culture and family, such as difficulty incorporating ethnic food into diabetes dietary guidelines and navigating household intergenerational conflict on management of T1D.
Conclusions: Black and Hispanic YA with T1D share common challenges to T1D self-management related to stage of development, but key differences exist between these racial/ethnic groups that should inform future interventions. For Black YA with T1D, addressing social determinants of health is an urgent initial need to help support diabetes self-management while for Hispanic YA, family and food-related conflict management is a priority.
M. Finnan: None. G. Crespo-ramos: None. S. Agarwal: None.
National Institutes of Health (K23DK115896)