THURS-100 - Technology Barriers and Facilitators for Type 1 Diabetes Self-care Monitoring and Self-care Management

Brief Abstract Summary: Self-care monitoring and self-care management of Type 1 Diabetes (T1D) requires effective technology. However, limited studies have used a theoretical framework to qualitatively explore college students living with T1D perceptions of using diabetes technologies. Therefore, this study identified the advantages and disadvantages of using diabetes technologies (i.e., medical devices and mobile applications) by incorporating a theoretical framework. College students (n=31) were interviewed one-on-one using a semi-structured interview guide. Data collection and analysis were theoretically informed. Two themes were created: 1) Technology Barriers for Self-Care Monitoring and Self-Care Management and 2) Technology Facilitators for Self-Care Monitoring and Self-Care Management. Three subthemes emerged for barriers, and four were identified for facilitators. Health education specialists should offer guidance on minimizing technology use concerns to increase patient engagement.

Detailed abstract description: College students living with Type 1 Diabetes (T1D) use technology for self-care monitoring and self-care management. Self-care monitoring involves measuring and recording changes in blood sugar levels. Self-care management includes adjusting self-care behaviors to regulate blood sugar levels when previous, habitual self-care behaviors are no longer effective. Although technology is essential for self-care monitoring and self-care management behaviors, limited studies have qualitatively explored college students living with T1D perception of the diabetes technologies barriers and facilitators through applying a theoretical framework. Therefore, the purpose of this study was to use the Middle-Range Theory of Self-Care of Chronic Illness to identify the efficient and insufficient features of diabetes technologies used for self-care monitoring and self-care management. Mean age was 20.13 years (SD = 1.28), most self-identified as White (n = 27), classified as a senior (n=10) and identified as a woman (n = 18). Mean time living with T1D was 7.94 (SD = 1.29) years. Ownership of medical supplies included an insulin pump (n=23) and a continuous glucose monitor (n=22). Data collection and analysis were theoretically informed. This present study involved a sub-analysis of the theoretical constructs, self-care monitoring and self-care management. Two themes were created: 1) Technology Barriers for Self-Care Monitoring and Self-Care Management and 2) Technology Facilitators for Self-Care Monitoring and Self-Care Management. Three subthemes emerged for barriers, and four were identified for facilitators. Subthemes for technology barriers included excessive notifications, inability to record specific food items, and limited suggestions on regulating blood sugar. Four subthemes for technology facilitators included meters for monitoring blood sugar levels and ketones, insulin pump activity mode, insulin pump control IQ, and insulin pump temporary basal rate settings. Health education specialists, such as certified diabetes care and education specialists, and other health education professionals should assist college students with their self-care monitoring behaviors (e.g., documenting nutritional impacts on blood sugar level) and self-care management behaviors (e.g., providing education on how to sustain blood sugar regulation). Additionally, college students with T1D self-care monitoring and self-care management behaviors should be routinely evaluated to address concerns as they occur. Although technology facilitators were present, some participants were unaware of these important features of diabetes technology. Therefore, health education professionals should inform this subpopulation on how to use their medical devices to monitor their ketones and assist with adjusting their medical device settings to support self-care management. Additional research is warranted to determine other barriers and facilitators experienced when using diabetes technologies.