Abstract
Objective: Spanish speaking (SS), Latino patients (LP) with type 1 diabetes (T1D) face cultural, language and socioeconomic barriers that add to the risk of complications and higher distress. Shared medical appointments (SMAs) are effective models of care to help overcome these barriers. Behavioral outcomes of SS LP with T1D attending a novel culturally sensitive SMA pilot were analyzed.
Methods: Patients 1-20 years old and caregivers participated in the SMA pilot program. Pediatric Quality of Life (PedsQL), Diabetes distress (Problem Areas in Diabetes-PAID) surveys and satisfaction scores were obtain baseline and yearly. Higher scores on PedsQL indicate a better overall QoL.
Results: Mean A1C at baseline was 9.6% (sd=2.3). Mean distress scores for children and teens decreased from Baseline to Year 2 (47.4 vs. 37.9; p=0.21 and 54.1 vs. 51.8; p=.002, respectively) and showed improvement (not statistically significant) on mean overall QoL. Diabetes specific QoL improved from Baseline to Year 1 (78.4 vs. 81.5, p=0.46 and 68.2 vs. 73.2, p=0.24, respectively). For caregivers from Baseline to Year 2 there was significant increase in distress (39.5 vs. 65.1, p<0.001), had no change in overall QoL, Diabetes specific QoL worsen from Baseline to Year 1 (64.5 vs. 57.9, p=0.04). Children, teens and parents all reported high levels of program satisfaction (means ranged from 41-46/50) with no significant change over time.
Conclusions: The novel culturally sensitive SMA model seems an effective strategy to lessen overall distress and increase QoL for High-risk SS LP youth. Parent’s final PAID scores correlated to children’s baseline A1C. It is likely that parent’s data was a result of increased education and awareness of disease seriousness. Sample size was small. Data from continued participation should be further analyzed.
Disclosure
R. Jensen: None. S. Suttiratana: Employee; Spouse/Partner; CVS Caremark. D. Naranjo: None. A. Gerard Gonzalez: None.
Funding
The Leona M. and Harry B. Helmsley Charitable Trust (2015PG-T1D060)