Solutions to Address Inequity in Diabetes Technology Use in Type 1 Diabetes: Results from Multidisciplinary Stakeholder Co-creation Workshops

• Published in: Diabetes technology & therapeutics Vol. 24; no. 6; p. 381
• Main Authors: Agarwal, Shivani, Crespo-Ramos, Gladys, Leung, Stephanie L, Finnan, Molly, Park, Tina, McCurdy, Katie, Gonzalez, Jeffrey S, Long, Judith A
• Format: Journal Article
• Language: English
• Published: United States 01.06.2022
• Subjects: Blood Glucose; Diabetes Mellitus, Type 1 - therapy; Humans; Racial Groups; Stakeholder Participation; Technology; United States; United States; Diabetes technology; Inequity; Disparities; Type 1 diabetes; Race–ethnicity; Minority
• DOI: 10.1089/dia.2021.0496

Racial-ethnic inequity in type 1 diabetes technology use is well documented and contributes to disparities in glycemic and long-term outcomes. However, solutions to address technology inequity remain sparse and lack stakeholder input. We employed user-centered design principles to conduct workshop sessions with multidisciplinary panels of stakeholders, building off of our prior study highlighting patient-identified barriers and proposed solutions. Stakeholders were convened to review our prior findings and co-create interventions to increase technology use among underserved populations with type 1 diabetes. Stakeholders included type 1 diabetes patients who had recently onboarded to technology; endocrinology and primary care physicians; nurses; diabetes educators; psychologists; and community health workers. Sessions were recorded and analyzed iteratively by multiple coders for common themes. We convened 7 virtual 2-h workshops for 32 stakeholders from 11 states in the United States. Patients and providers confirmed prior published studies highlighting patient barriers and generated new ideas by co-creating solutions. Common themes of proposed interventions included (1) prioritizing more equitable systems of offering technology, (2) using visual and hands-on approaches to increase accessibility of technology and education, (3) including peer and family support systems more, and (4) assisting with insurance navigation and social needs. Our study furthers the field by providing stakeholder-endorsed intervention ideas that propose feasible changes at the patient, provider, and system levels to reduce inequity in diabetes technology use in type 1 diabetes. Multidisciplinary stakeholder engagement in disparities research offers unique insight that is impactful and acceptable to the target population.