Location: Children's Nutrition Research CenterTitle: Barriers and facilitators to involvement in children's diabetes management among minority parents
|BUTLER, ASHLEY - Baylor College Of Medicine|
|HILLIARD, MARISA - Baylor College Of Medicine|
|TITUS, COURTNEY - Baylor College Of Medicine|
|RODRIGUEZ, EVADNE - Baylor College Of Medicine|
|AL-GADI, IMAN - Baylor College Of Medicine|
|COLE-LEWIS, YASMIN - Baylor College Of Medicine|
|Thompson, Deborah - Debbe|
Submitted to: Journal of Pediatric Psychology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/21/2019
Publication Date: 1/29/2020
Citation: Butler, A.M., Hilliard, M.E., Titus, C., Rodriguez, E., Al-Gadi, I., Cole-Lewis, Y., Thompson, D.J. 2020. Barriers and facilitators to involvement in children's diabetes management among minority parents. Journal of Pediatric Psychology. https://doi.org/10.1093/jpepsy/jsz103.
Interpretive Summary: Family involvement is important in the management of type 1 diabetes in children. Although racial/ethnic differences in health outcomes have been identified, little is known about racial/ethnic differences in family perceptions regarding barriers and facilitators to parental involvement in type 1 diabetes management tasks. Semi-structured interviews with Hispanic and African-American parents of children with type 1 diabetes revealed that diverse psychological, interpersonal, environmental, and motivational factors contribute to parental involvement in diabetes management tasks. Few racial/ethnic differences were observed, suggesting there are many similarities among Latino and African-African parents of children with diabetes. This work highlights that multi-disciplinary teams of health professionals are needed to support parents of children with type 1 diabetes. This work can inform multi-level interventions to maximize parental involvement in type 1 diabetes management and promote positive health outcomes in Latino and African-American children with diabetes.
Technical Abstract: This study aimed to describe parents' perceptions of the factors that facilitate or are barriers to their involvement in children's type 1 diabetes (T1D) management among African American and Latino parents. African American and Latino parents (N=28) of 5- to 9-year-old children with T1D completed audio-recorded, semi-structured interviews that were transcribed and analyzed using thematic analysis. Themes were identified that aligned with the theoretically-derived Capability-Opportunity-Motivation-Behavior (COM-B) framework. Parents described Capability-based facilitators of parent involvement, including positive stress management, religious/spiritual coping, organizational/planning skills, and diabetes knowledge. Capability-based barriers included child and parent distress. Interpersonal relationships, degree of flexibility in work environments, and access to diabetes technologies were both Opportunity-based facilitators and barriers; and Opportunity-based barriers consisted of food insecurity/low financial resources. Parents' desire for their child to have a "normal" life was described as both a Motivation-based facilitator and barrier. African American and Latino families described helpful and unhelpful factors that spanned all aspects of the COM-B model. Reinforcing or targeting families' unique psychological, interpersonal, and environmental strengths and challenges in multilevel interventions has potential to maximize parental involvement in children's diabetes management.