African American Youth and Parent Perspectives on Advanced Insulin Delivery Technologies in Diabetes Management: Challenges to Closing the Loop on Health Disparities

PurposeThe purpose of the study was to understand challenges to optimal diabetes management for African American (AA) youth and willingness to use advanced diabetes technologies.MethodsTwenty AA youth with type 1 diabetes mellitus (mean age 13.81 ± 2.10 years; 8 girls and 12 boys) and their parents participated in focus groups or individual interviews addressing adherence barriers and attitudes about new technologies, such as the advanced hybrid closed loop (AHCL) insulin pump. Sessions were video recorded, and based on verbatim transcripts, 2 independent raters coded responses into themes, and a third rater resolved discrepancies; thematic analysis was conducted using NVivo.ResultsQualitative analyses revealed 6 main themes encompassing current regimens, life with diabetes, parenting, culture, willingness to try new technologies, and hesitancy to try an AHCL system. Most families (65%) reported being very willing to try the AHCL system, and a third were open but not ready to commit, citing concerns about reliance on technology and need for more information.ConclusionsInnovative technology, such as the AHCL insulin pump system, may help to improve glycemic outcomes and reduce health disparities for AA youth. Many AA youth with type 1 diabetes mellitus and their parents are ready to try advanced technologies but may require additional individualized support from the health care team to achieve optimal outcomes.