1183-P: Integrating Schools into Diabetes Device Interventions for Underserved Youth with Type 1 Diabetes (T1D)

Interventions that increase diabetes tech use reduce inequity in outcomes for underserved youth with T1D, but are usually clinic and not-school based, despite youth spending most of their time in school. We employed user-centered design methodology to incorporate perspectives of school-based health providers (SBHP) into future diabetes tech interventions that extend to school, that may increase efficacy, acceptability, and sustainability. We conducted 17 virtual workshops to discuss barriers and facilitators of youth device use and co-create multidisciplinary solutions to increase use. Workshops included 14 youth ages 13-17 yo; 23 parents; and 6 school-based and 11 clinic-based healthcare providers from Children’s Hospital at Montefiore and Montefiore School Health Program. Here, we report data from SBHP and clinic providers. Workshop recordings were thematically analyzed by 3 independent coders, using an inductive coding approach. Both SBHP and clinic-based providers endorsed benefits of devices, citing the need for its prioritization for medical and educational well-being, and an interest to support more device use. School-based barriers included limited communication with clinic-based providers and expertise in managing devices. Clinic-based barriers included navigating insurance coverage and having limited time to adequately introduce families to devices. Common barriers among providers included lack of time to address and help families with device or supply issues. Overall themes for co-created solutions by SBHP and clinic-based providers included the need for extra staff to help families navigate the healthcare system, specialized device troubleshooting support, and streamlined communication between clinic and school. Adding SBHP perspectives to inform the development of a device intervention for youth with T1D has defined new targets. These include enhanced communication between clinic and school and bolstering education of SBHP on devices.