The experience of discrimination impacts technology readiness and psychosocial states of minoritized families living with type 1 diabetes: Findings from the BEAD-T1D Pilot study.

Abstract

Objectives: This study aims to understand the association of perceived discrimination with diabetes technology utilization and psychosocial states in minoritized families with public insurance and pediatric type 1 diabetes.

Methods: The Building the Evidence to Address Disparities in Type 1 Diabetes Pilot (BEAD-Pilot) study engaged parents/guardians of children aged<12 years with type 1 diabetes and public insurance. Parents/guardians were invited to participate in surveys, focus groups, and/or advisory groups. Surveys included validated measures assessing perceived discrimination, psychosocial factors, and diabetes technology acceptance. Data were analyzed via descriptive statistics, group comparisons, and regressions. Through semi-structured interviews we explored barriers to diabetes technology use and data were coded inductively by a five-member bilingual group.

Results: Discrimination correlated with lower diabetes technology acceptance (r=-0.38, p=0.05). Higher perceived discrimination was significantly associated with increased depression (β=0.45, p<0.001) and decreased global health (β=-0.27, p=0.011). Qualitative data revealed that parents experienced discrimination based on race, ethnicity, and insurance status, often leading to mistrust and reluctance to engage in care.

Conclusions: Perceived discrimination appears to be an underexplored but meaningful barrier to diabetes technology utilization. Addressing discrimination in healthcare and community settings, in addition to access, is essential for closing disparities in diabetes technology utilization.