A Qualitative Study of Cognitive, Behavioral, and Psychosocial Challenges Associated With Pediatric Type 2 Diabetes in Ethnic Minority Parents and Adolescents

Abstract

Purpose The purpose of this descriptive qualitative study was to explore cognitive, behavioral, and psychosocial challenges associated with having and/or parenting an adolescent with pediatric type 2 diabetes (T2D) from the perspectives of ethnic minority parents and adolescents. Methods Ethnic minority (79.2% non-Hispanic black, 29.6% Hispanic) adolescents (n = 14, 78.6% female, 14.7 ± 1.9 years) and their parents (n = 13, 100% female) participated in either individual family interviews or multifamily focus group sessions. Sessions were audio recorded, transcribed, and coded by a team of 4 raters. QSR NVivo 10 was used to perform a content analysis and to extract coded adolescent and parent responses. Results Six themes corresponding to 3 broad categories (cognitive, behavioral, and psychosocial challenges) emerged. Regarding cognitive challenges, families described difficulties learning about a new disease and managing youth knowledge deficits and/or superficial knowledge. In terms of behavioral challenges, parents and adolescents discussed ongoing difficulties with making and maintaining positive youth health behavior changes as well as with ensuring regimen adherence. Finally, managing youth emotions related to diabetes and navigating social relationships with peers and other family members around the disclosure of T2D were the primary psychosocial challenges to emerge. Conclusions Directions for future research include developing and evaluating brief family interventions and adolescent psychosocial screening measures. Recommendations for clinical practice include increasing family knowledge of T2D, enhancing parenting skills for managing youth behavior change, and conducting routine psychosocial screening during follow-up clinic visits.

The Burden of Type 2 Diabetes and the Value of Achieving Near Normoglycemia from the Patient Perspective

“…As novel therapies are developed with potential for better outcomes, including the possibility of achieving near normoglycemia [21], it is important to understand how people with T2D view the benefits and risks associated with new treatment options. The results of the current study and prior studies suggest that participants have extremely varied experiences and perspectives in terms of their diagnostic and treatment histories and their perceptions of the impact of T2D on their lives [26][27][28][29]. However, to date, there has been very little research on the perceptions and expectations of people with diabetes about their future with the condition.…”

Secondary benefits of the families improving together (FIT) for weight loss trial on cognitive and social factors in African American adolescents

“…A follow-up training session was conducted to discuss any questions the evaluators had prior to the administration of the fourteen transcripts. Initial percentage of agreement was 62% on independently coded transcripts, with coding pairs reaching 100% consensus on all final codes through discussion, for a similar approach see St George et al, 2017 [34].…”

On a Different Page! Perceptions on the Onset, Diagnosis, and Management of Type 2 Diabetes Among Adolescent Patients, Parents, and Physicians

“…8 Furthermore, investigations on adolescents and parents' perceptions prior to, and at the point when a diagnosis of T2D is made were rare, as studies have mainly focused on the perceptions about self-management after diagnosis. [9][10][11][12] Based on previous studies, the perceived likelihood of receiving a T2D diagnosis among the general population of adolescents and their parents appears to be low, even when adolescents have existing risk factors like obesity. 13 The perceived risk of T2D not only affects the process of receiving a diagnosis, but also plays an important role in adolescents' participation in health promoting behaviors that contribute to T2D prevention and management.…”

“…8 Furthermore, investigations on adolescents and parents’ perceptions prior to, and at the point when a diagnosis of T2D is made were rare, as studies have mainly focused on the perceptions about self-management after diagnosis. 9-12…”