1186-P: Considerations for a Community Health Worker Enhanced Strategy to Address Racial Disparities in Youth Use of Diabetes Technology

Introduction: Disparities by race in the use of diabetes technology by youth with T1DM risk exacerbating inequities in health outcomes among Black youth with T1DM. In preparation for a feasibility trial of an intervention to increase use of diabetes technology by Black youth, the purpose of this analysis was to define expectations for how a community health worker (CHW) might promote facilitators and address barriers to sustained adoption of diabetes technology.

Methods: Semi-structured interviews followed by 3 focus groups were conducted January-June 2023 with patients, caregivers, and healthcare workers in Ohio who had at least some experience with diabetes technology and/or CHWs. Content analysis was used to summarize participants’ perceptions regarding general barriers and facilitators to adoption of diabetes technology, and also specific feedback regarding the proposed intervention.

Results: Participants were 7 young adults with T1DM, 10 parents of a child with T1DM, and 11 healthcare workers. All young adults and parents plus 4 healthcare stakeholders identified as Black. Participants were favorable toward the proposed CHW intervention, emphasizing that CHWs should have similar lived experience to families in terms of both racial background and personal familiarity with T1DM. Stakeholder recommendations for the proposed intervention included: (1) CHW function -provide social and technical support to families, liase between family/community and healthcare team; (2) CHW tasks - identify and trouble shoot common barriers to wearing devices, acquisition of supplies, digital connectivity, and/or parent-child conflict regarding diabetes management; (3) CHW workflow - foster family-centeredness through flexibility in encounter location, format, frequency and duration.

Conclusion: CHW integration into the proposed intervention may promote equity for Black youth with T1DM by liaising between patient, clinical team, and community.