Involvement of Racially and Ethnically Minoritized Youths in Behavioral Type 1 Diabetes Interventions: A Systematic Review.

OBJECTIVE: Psychosocial interventions targeting glycemic health in youth with type 1 diabetes (T1D) have been promising. Nonetheless, disparities in T1D treatment and outcomes are pervasive among racially/ethnically minoritized (REM) youth and a systematic review examining the inclusion of REM youth in psychosocial interventions is lacking. Therefore, the present systematic review examined the literature to determine the inclusion of REM youth with T1D in psychosocial interventions. METHODS: A systematic literature review was conducted per PRISMA guidelines for psychosocial intervention studies of youth (<19 years) with T1D between 2011 and 2022 using PubMed, PsycINFO, CINAHL, and MedLine. Tables of contents for JPP, CPPP, and Diabetes Care were also reviewed. The date last searched was April 26, 2022. Studies were examined for risk of bias using the QualSyst rating system. RESULTS: Twenty-four studies met inclusion criteria with a total of 3,117 participants. Studies utilized various psychological interventions (e.g., CBT, MI, behavioral modalities). Seventeen studies reported participants' race/ethnicity and eleven studies included >20% REM youth. CONCLUSIONS: One study examined the impact of interventions on REM youth or whether the intervention reduces existing racial/ethnic disparities. Implications for future research and practice are discussed.

Psychosocial Impact of the COVID-19 Pandemic in Racially/Ethnically Diverse Youth With Diabetes.

OBJECTIVE: This study examined caregiver perceived impact of the Coronavirus Disease 2019 (COVID-19) pandemic on a diverse sample of U.S. youth with diabetes and their families. METHODS: Caregivers of youth with diabetes completed an electronic survey in English or Spanish at two sites. Participants provided demographic and disease characteristics and completed the COVID-19 Exposure and Family Impact Scales (CEFIS). Glycemic health was assessed via Hemoglobin A1c (HbA1c) from medical chart review. Analysis of variance and analyses of covariance were utilized to examine racial/ethnic differences in glycemic health and in COVID-19 Exposure, Impact, and Distress scales. Hierarchical linear regression was conducted to predict HbA1c. Thematic analysis was conducted on open-ended responses regarding the effects of COVID-19 on youth and families' overall and diabetes-related well-being. RESULTS: Caregivers (n = 114) of youth with diabetes (M = 12.6 ± 3.5 years) completed study measures. Mean HbA1c for Non-Hispanic White youth was lowest and significantly different from Hispanic and Non-Hispanic Black youth. Exposure to COVID-19 stressors differed by race/ethnicity (p < .05) with Hispanic caregivers reporting greatest exposure. CEFIS scales did not predict HbA1c after controlling for demographic/disease variables. Caregivers described child/family changes during COVID (e.g., more time together, health-related hypervigilance), as well as differences in diabetes management during COVID-19. CONCLUSIONS: Findings indicate differences in COVID-19 exposure but did not demonstrate other racial/ethnic disparities in COVID-19 impact or distress. Household income was the most important predictor of glycemic health. Addressing structural inequalities experienced by youth with diabetes and their families is critical. Recommendations to support families with diabetes are made.

Provider-Guided Emergency Support for Persons Living With Type 1 Diabetes During Hurricanes Harvey, Irma, and Maria.

The 2017 Atlantic hurricane season was especially memorable for 3 major hurricanes-Harvey, Irma, and Maria-that devastated population centers across Texas, Florida, and Puerto Rico, respectively. Each storm had unique hazard properties that posed distinctive challenges for persons living with type 1 diabetes (T1D). Diabetes care specialists and educators took on leadership roles for coordinating care and establishing insulin supply lifelines for people with T1D living in the hardest-hit neighborhoods affected by these extreme storms. Strategies and resources were customized for each population. Diabetes specialists strategized to provide mutual support and shared insulins and supplies across sites.