A Qualitative Study of Cognitive, Behavioral, and Psychosocial Challenges Associated With Pediatric Type 2 Diabetes in Ethnic Minority Parents and Adolescents.
Purpose The purpose of this descriptive qualitative study was to explore cognitive, behavioral, and psychosocial challenges associated with having and/or parenting an adolescent with pediatric type 2 diabetes (T2D) from the perspectives of ethnic minority parents and adolescents. Methods Ethnic minority (79.2% non-Hispanic black, 29.6% Hispanic) adolescents (n = 14, 78.6% female, 14.7 ± 1.9 years) and their parents (n = 13, 100% female) participated in either individual family interviews or multifamily focus group sessions. Sessions were audio recorded, transcribed, and coded by a team of 4 raters. QSR NVivo 10 was used to perform a content analysis and to extract coded adolescent and parent responses. Results Six themes corresponding to 3 broad categories (cognitive, behavioral, and psychosocial challenges) emerged. Regarding cognitive challenges, families described difficulties learning about a new disease and managing youth knowledge deficits and/or superficial knowledge. In terms of behavioral challenges, parents and adolescents discussed ongoing difficulties with making and maintaining positive youth health behavior changes as well as with ensuring regimen adherence. Finally, managing youth emotions related to diabetes and navigating social relationships with peers and other family members around the disclosure of T2D were the primary psychosocial challenges to emerge. Conclusions Directions for future research include developing and evaluating brief family interventions and adolescent psychosocial screening measures. Recommendations for clinical practice include increasing family knowledge of T2D, enhancing parenting skills for managing youth behavior change, and conducting routine psychosocial screening during follow-up clinic visits.
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida (Dr St. George).
Sara M
SM
St George
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida (Dr Pulgarón, Ms Agosto, Ms Toro, Mr Ramseur, Dr Delamater).
Elizabeth R
ER
Pulgarón
School of Nursing and Health Studies, University of Miami, Coral Gables, Florida (Ms Ferranti).
Dina
D
Ferranti
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida (Dr Pulgarón, Ms Agosto, Ms Toro, Mr Ramseur, Dr Delamater).
Yaray
Y
Agosto
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida (Dr Pulgarón, Ms Agosto, Ms Toro, Mr Ramseur, Dr Delamater).
Maria I
MI
Toro
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida (Dr Pulgarón, Ms Agosto, Ms Toro, Mr Ramseur, Dr Delamater).
Kevin C
KC
Ramseur
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida (Dr Pulgarón, Ms Agosto, Ms Toro, Mr Ramseur, Dr Delamater).
Alan M
AM
Delamater
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001741:Black or African American / Q000523:psychology; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000523:psychology*; D005006:Ethnicity / Q000523:psychology; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012919:Social Behavior