Who Needs Diabetes Education? A Qualitative Analysis of Emerging Adults With Type 1 Diabetes

Abstract

Background The purpose of this study is to explore the diabetes self-management education (DSME) needs of emerging adults with type 1 diabetes mellitus (T1DM) because addressing these needs may facilitate optimal glycemic management during this challenging transitional period. Methods A hybrid qualitative design was utilized. Emerging adults and parents of emerging adults were recruited from endocrinology and primary care clinics and through a Utah-specific T1DM online community. Interviews were conducted to asses needs to achieve target A1C. Data were interpreted thematically. Results Emerging adults with T1DM (N = 33) and parents of emerging adults with T1DM (N = 17) were interviewed. Three main themes emerged: (1) mixed desire for personal DSME; (2) I don’t need the education, others do; and (3) health care provider (HCP) attributes that make a difference. Associated subthemes were reported. Conclusions Emerging adults reported that further education for themselves was not needed, although newly diagnosed individuals would benefit from increased training in diabetes management. Although many emerging adults had a supportive social network, they endorsed the need for greater public education to avoid diabetes misinformation. Emerging adults felt more connected with HCPs that had diabetes-specific training (ie, endocrinologist) or those who personally live with T1DM.

The Feasibility and Acceptability of a Community-Developed Health Insurance and Financial Toolkit for Emerging Adults With Type 1 Diabetes

“…22 Emerging adults who receive diabetes self-management education services desire integration of real-world problem-solving to diabetes barriers that may present. 23 Additionally, peer support via online media is often a preferred way to receive resources. 24,25 The T1D Financial Toolkit is a simple resource that diabetes care and education specialists can utilize to prompt discussions about relevant health insurance and financial challenges emerging adults might face and strategize solutions.…”

Diabetes care in the pandemic era in the Midwestern USA: a semi-structured interview study of the patient perspective

“…MAXQDA (V.22.1.1) was used to conduct thematic analysis across transcripts as follows: a qualitative codebook with a priori deductive codes was developed using the interview guide and preliminary themes based on literature review,14–29 and inductive codes were developed during transcript review and analyst discussion. Each transcript was independently coded in its original language by three coders who were fluent in the language in which the interview was conducted.…”

“…4 10 To equitably address the complex and evolving needs of diabetes care in the pandemic and post-pandemic eras, research must adequately capture the context of care among patients and health systems in communities that are disparately affected by these challenges and yet often underrepresented in research. 13 Prior research has found that social determinants of health, such as financial factors, access to healthcare and psychosocial support have substantial impacts on patients' experience with and outcomes of diabetes care [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and that these experiences can differ across other, intersecting factors, 19 such as race, ethnicity, language and rurality. However, few of these prior studies were conducted during or after the pandemic's onset, with most recent studies examining the experiences of patients living outside the USA during that time.…”

“…All recordings and transcripts were stored on secure university drives accessible only to members of the study team and retained for further review throughout the analysis. MAXQDA (V.22.1.1) was used to conduct thematic analysis across transcripts as follows: a qualitative codebook with a priori deductive codes was developed using the interview guide and preliminary themes based on literature review, [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and inductive codes were developed during transcript review and analyst discussion. Each transcript was independently coded in its original language by three coders who were fluent in the language in which the interview was conducted.…”

“…Prior research has found that social determinants of health, such as financial factors, access to healthcare and psychosocial support have substantial impacts on patients’ experience with and outcomes of diabetes care14–29 and that these experiences can differ across other, intersecting factors,19 such as race, ethnicity, language and rurality. However, few of these prior studies were conducted during or after the pandemic’s onset, with most recent studies examining the experiences of patients living outside the USA during that time.…”