Financial stress in emerging adults with type 1 diabetes in the United States

Blanchette, Julia E.; Toly, Valerie Boebel; Wood, Jamie

doi:10.1111/pedi.13216

Cited by 18 publications

(6 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent awareness of cost concerns suggests that this worry is particularly meaningful for emerging adults living in the United States given the complexities of health care cost and access in this country. 39 Many participants identified multiple dimensions of worry about cost from 1 very simple question and connected it to worries about insurance although that topic was not specifically addressed in the survey. The findings suggest that the worry about the cost of diabetes is rather complicated and includes disparate aspects, such as access to care, finding employment, and fear about turning 26 and aging out of parental insurance coverage.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Distress in Emerging Adulthood: Content Validity of the Problem Areas in Diabetes—Emerging Adult Version (PAID-EA) Using Qualitative Analysis

Wentzell

Vitale

Laffel

2022

The Science of Diabetes Self-Management and Care

View full text Add to dashboard Cite

Purpose: The purpose of this study was to explore the emotional work of diabetes during emerging adulthood and to explicate the validity of a newly developed measure of diabetes distress (DD) for use with emerging adults living with type 1 diabetes mellitus (T1DM), the Problem Areas in Diabetes—Emerging Adult version (PAID-EA). Methods: Young people ages 18 to 30 with T1DM were recruited online to complete a cross-sectional survey including measures of DD, depressive symptomology, and the PAID-EA. To evaluate content validity, 2 open-ended questions asked what was the most significant emotion or worry discussed in the survey items and what feelings were missed in those items. Responses were analyzed using directed qualitative content analysis. Results: A total of 254 (87%) participants responded to at least 1 of the 2 open-ended questions. Three themes and 1 subtheme were identified: (1) fear of the future with the subtheme of worry about the cost of diabetes, (2) acute worries about living with diabetes, and (3) challenges with finding support. More PAID-EA items corresponded with these themes than items on the original Problem Areas in Diabetes or Center for Epidemiologic Studies Depression Scale, supporting the validity of the PAID-EA and clarifying the developmental-stage-specific aspects of DD. Conclusions: Emerging adulthood is a period in which the future should hold infinite possibility, but young people with T1DM describe a staggering fear of the future with markedly limited possibilities, supporting the need to measure the developmental-stage-specific experience of DD as captured on the PAID-EA.

show abstract

Section: Discussionmentioning

confidence: 99%

Diabetes Distress in Emerging Adulthood: Content Validity of the Problem Areas in Diabetes—Emerging Adult Version (PAID-EA) Using Qualitative Analysis

Wentzell

Vitale

Laffel

2022

The Science of Diabetes Self-Management and Care

View full text Add to dashboard Cite

show abstract

“…Individuals may use various strategies to cope with these circumstances, both adaptive and maladaptive. Much of the literature describing burden, stress, or coping driven by the financial and resource aspects of managing diabetes includes one or more of these areas based on data availability ( Caraballo et al, 2020 Feb , Mszar et al, 2020 May 18 , Shi et al, 2021 Jun , Blanchette et al, 2021 Aug , Patel et al, 2016 Aug ) Among people with Type 1 diabetes, Blanchette et al found that 21% of the variance in HbA1c is explained by greater financial stress ( Blanchette et al, 2021 Aug ) Using data from the National Health Interview Survey, multiple studies have shown high prevalence of food insecurity, inability to pay medical bills, financial stress, and cost-related non-adherence (CRN) behaviors among people with diabetes ( Patel et al, 2016 Aug , Caraballo et al, 2020 Feb , Mszar et al, 2020 May 18 ). However, these national studies demonstrate associations between those with diabetes and disease-agnostic indicators of burden, stress, and coping behaviors.…”

Section: Introductionmentioning

confidence: 99%

Economic burden, financial stress, and cost-related coping among people with uncontrolled diabetes in the U.S

Patel

Tolentino

Smith

et al. 2023

Preventive Medicine Reports

View full text Add to dashboard Cite

“…stress of costly diabetes care and low HIL both negatively impact HbA1c, insurance coverage, diabetes care, and out-of-pocket costs (11)(12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

Empowering Emerging Adults with Type 1 Diabetes: Crafting a Financial and Health Insurance Toolkit through Community-Based Participatory Action Research

Blanchette,

Lewis,

Shannon

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Emerging adults aged 18-30 years face challenges during life transitions, with an added burden of navigating the health care system and additional costs associated with diabetes. This stress is compounded by overall low levels of health insurance literacy in this population, as people may not know about available financial and health care resources to minimize suboptimal diabetes outcomes. This study aimed to tailor a financial and health insurance toolkit to emerging adults with type 1 diabetes, including racially, ethnically diverse, and Medicaid-insured individuals, through community-based participatory action research. Methods: An academic research team and citizen scientists from a national organization held six online community advisory board (CAB) content-creation meetings to understand how to tailor a financial and health insurance toolkit. The CAB comprised six racially and insurance-diverse emerging adults with type 1 diabetes and four content experts (clinical, financial, and insurance). A deductive thematic qualitative analysis was utilized. Three researchers independently coded the data and then convened to reach group consensus. Two CAB members performed member-checking. Results: The following key themes emerged to tailor the toolkit: ensuring that content covers empowerment and self-advocacy, including genuine stories and multimedia visuals for aesthetics, addressing clinician bias, acknowledging racial and ethnic disparities in care, incorporating cultural representation, and demystifying Medicaid stigma. Conclusions: By successfully partnering with the CAB and a community organization through a community-based participatory action research approach, we will develop a financial and health insurance Toolkit tailored to the needs of racially and ethnically diverse and Medicaid-insured emerging adults with type 1 diabetes.

show abstract

Financial stress in emerging adults with type 1 diabetes in the United States

Cited by 18 publications

References 36 publications

Diabetes Distress in Emerging Adulthood: Content Validity of the Problem Areas in Diabetes—Emerging Adult Version (PAID-EA) Using Qualitative Analysis

Diabetes Distress in Emerging Adulthood: Content Validity of the Problem Areas in Diabetes—Emerging Adult Version (PAID-EA) Using Qualitative Analysis

Economic burden, financial stress, and cost-related coping among people with uncontrolled diabetes in the U.S

Empowering Emerging Adults with Type 1 Diabetes: Crafting a Financial and Health Insurance Toolkit through Community-Based Participatory Action Research

Contact Info

Product

Resources

About