Population Screening for Type 1 Diabetes in Pediatrics via Well-Child Visits: Barriers and Facilitators to Implementation.
OBJECTIVE: Screening for type 1 diabetes provides an opportunity to identify those with presymptomatic, early-stage disease, enabling increased monitoring to prevent diabetic ketoacidosis and facilitating access to emerging therapies. Given potential benefits, discussions about population-wide type...
| Publicado en: | Diabetes Spectrum Vol. 38; no. 5; pp. 572 - 587 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Diabetes Association
Bonus2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190770926&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190770926 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10409165 6FW jtl: Diabetes Spectrum issn: 10409165 maglogo: N pubinfo: dt: Bonus2025 vid: 38 iid: 5 pid: 1367 pub: American Diabetes Association place: Arlington, Virginia artinfo: ui: 190770926 190770926 190770926 10.2337/ds25-0036 190770926 ppf: 572 ppct: 15 formats: tig: atl: Population Screening for Type 1 Diabetes in Pediatrics via Well-Child Visits: Barriers and Facilitators to Implementation. aug: au: Klaczko, Christie Gilbert Walters, Nicole Blackburn, Alexis E. Brangan, Andrew Campbell-Salome, Gemme Goehringer, Jessica Ilango, Lakshmi Nixon, Michelle Pistner Romagnoli, Katrina M. Van Enkevort, Erin A. Savatt, Juliann M. Jones, Laney K. affil: Department of Genomic Health sug: subj: Diabetes Mellitus, Type 1 Diagnosis Health Screening Methods Child Health Services Office Visits Pediatric Care Health Services Accessibility Program Implementation Outcomes (Health Care) Funding Source Pennsylvania Human Male Female Adult Middle Age Semi-Structured Interview Interview Guides Qualitative Studies Data Analysis Software Thematic Analysis Quantitative Studies Descriptive Statistics Wilcoxon Signed Rank Test Implementation Science Surveys Questionnaires Coefficient alpha Electronic Health Records Insurance, Health Medicaid Hypercholesterolemia, Familial Waiting Lists Personnel Staffing and Scheduling Health Education Health Literacy Patient Attitudes Pilot Studies Primary Health Care Stakeholder Participation Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: OBJECTIVE: Screening for type 1 diabetes provides an opportunity to identify those with presymptomatic, early-stage disease, enabling increased monitoring to prevent diabetic ketoacidosis and facilitating access to emerging therapies. Given potential benefits, discussions about population-wide type 1 diabetes screening are ongoing. Routine primary care visits could offer a scalable approach to such screening. We used mixed methods to explore multilevel barriers to and facilitators of type 1 diabetes autoantibody screening at well-child visits and, more broadly, the acceptability, appropriateness, and feasibility of such a screening approach. RESEARCH DESIGN AND METHODS: Semi-structured interviews were completed with parents, clinicians, and health insurers. Transcripts were double coded using an iteratively adapted a priori codebook. A survey leveraging the validated Acceptability of Implementation, Intervention Appropriateness, and Feasibility of Intervention Measures instruments was deployed to assess pediatric primary care clinician perspectives. RESULTS: A total of 26 parents, 10 clinicians (endocrinologists and pediatricians), and two health insurers participated in interviews, and 15 pediatricians participated in the survey. Most parents interviewed and clinicians surveyed found type 1 diabetes screening acceptable and appropriate. Parents noted lack of education, need for a blood draw, costs, difficulty scheduling, and fear of results as barriers. Clinicians reported barriers including parental views on blood draws and clinician time. Insurers described lack of insurance coverage as a barrier. Facilitators across constituents included education, reduced costs, convenient screening, guidelines supporting screening, and institutional support. CONCLUSION: If population screening for type 1 diabetes is pursued, models that integrate primary care will be needed. Screening for type 1 diabetes through primary care well-child visits could enable high adoption if implementation strategies adequately address described barriers and promote facilitators. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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