572-P: Perspectives on the SDOH and CGM Uptake in Latino Adults with Type 1 Diabetes

Introduction & Objective: Little is known about the social determinants of health (SDOH) and uptake of continuous glucose monitoring (CGM) in Latino adults with type 1 diabetes (T1D). This study explores SDOH as barriers to CGM uptake in Latino adults with T1D from the perspective of Latino health advocates (LHAs), diabetes health care providers (HCPs), and federally qualified health center (FQHC) HCPs.

Methods: In this qualitative study, convenience sampling was used to recruit: (1) LHAs (n=7); (2) diabetes HCPs (n=4); and (3) FQHC HCPs (n=5) to participate in focus groups, respectively. Participants were queried about SDOH as barriers to CGM uptake in Latino adults with T1D. Content analysis was used to analyze data.

Results: The LHA, diabetes HCP, and FQHC HCP groups all identified suboptimal health care quality as a potent barrier to CGM uptake, particularly in terms of poor translation (literal, abbreviated, and culturally insensitive translations) of key health concepts by certified Spanish/English medical interpreters. The LHA and diabetes HCP groups revealed that providers may limit health care access to CGM based on translation issues, insurance hassles, and unsuccessful CGM uptake experienced previously with Latinos. The FQHC HCP group identified unreliable transportation to clinic visits as an impediment to health care access for CGM while food and housing insecurity, due to a lack of economic stability, were barriers to CGM uptake. With respect to the social and community context, lack of family inclusion in clinic visits and negative family/neighborhood perceptions of CGM were viewed as salient barriers.

Conclusion: Findings indicate that interventions targeting CGM uptake in Latino adults with T1D address SDOH barriers.