Can Behavioral Interventions Promote Health Equity in Pediatric Type 1 Diabetes? A Narrative Review of Promising Treatments

PURPOSE OF REVIEW: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes. RECENT FINDINGS: While existing behavioral interventions demonstrated efficacy in improving health and/or psychosocial outcomes, evidence that these same interventions may improve health equity were lacking. Most interventions were evaluated using predominantly White and affluent samples and some studies did not report on racial, ethnic, or sociodemographic characteristics of their sample. Only a few interventions have been adapted for youth from minoritized backgrounds. Recent multisystemic and technology/mHealth interventions recruited samples that were sociodemographically representative of youth experiencing disparities, suggesting that these interventions could improve health and/or psychosocial outcomes for these sociodemographic groups. However, no studies conducted subgroup analyses to examine whether the effect of the intervention might vary as a function of sociodemographic characteristics. The prevalence and persistence of disparities in psychosocial and glycemic outcomes among youth with T1D underscore the urgent need for effective, evidence-based behavioral interventions for populations in most need of this care. There is a critical need for research that prioritizes recruitment of samples that represent youth most impacted by health disparities. Additionally, existing interventions can be adapted for youth from minoritized backgrounds. Future research would benefit from leveraging existing intervention development/adaptation frameworks and engaging community partners through the research process.