2. Professor Emerita, University of California, Irvine Sue & Bill Gross School of Nursing 802 W Peltason Drive Irvine, CA 92697, USA.
3. University of California, Irvine, Sue & Bill Gross School of Nursing, 802 W Peltason Drive Irvine, CA 92697, USA.
4. CHOC Children’s Endocrine Division, 1201 W. La Veta Ave Orange, Ca, USA.
5. Consortium for Independent Research, 512 E. 27th Street Vancouver, WA, USA.
6. University of California, Irvine, Department of Medicine 100 Theory, Suite 110 Irvine, CA, USA.
7. MD, MPH, FAAP UPMC Children’s Hospital of Pittsburgh, Oakland Medical Building, 3420 Fifth Ave. Pittsburgh, PA, USA.
8. University of California, Irvine School of Medicine, 333 The City Blvd. West, Suite 800 Orange, CA, USA.
9. University of California, Irvine, Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, UC Irvine School of Medicine, 101 Academy, Suite 150 Irvine, CA, USA.
Background: Latinas are at a higher risk than Caucasians for both type 1 and type 2 diabetes (DM), as well as DM-associated reproductive health (RH) complications. Healthcare providers (HCPs) should deliver culturally-sensitive care to enhance the care relationship between Latinos and HCPs and to improve patient outcomes. This study explored an expert panel’s cultural understanding, experiences, barriers, and facilitators regarding RH and preconception counseling (PC) for adolescent Latinas with DM and their families.
Methods: This study used open-ended questions with a focus group of 8 HCPs from the mid-Atlantic, Southwest, and Northwest regions of the United States in a teleconference format. Two researchers transcribed and reviewed the transcript for accuracy. Using content analysis, four members of the team identified themes. All researchers discussed themes and a 100% consensus was reached. For confirmation, a coding protocol was created based on the emerging themes.
Results: Five themes related to cultural understanding and experiences were identified: 1) issues of identity; 2) acculturation; 3) stigma; 4) ambivalence toward birth control, RH education, and PC; and 5) cultural sensitivity vs. best practice. Four barriers were identified: 1) language; 2) religion; 3) access to healthcare, and 4) discomfort with discussion. Ten facilitators were identified: 1) the importance of support and support networks; 2) promoting trust among HCPs, daughters, and families; 3) assessing emotional development; 4) empowerment; 5) emphasizing safety; 6) communicating in patients’ preferred language; 7) discussing RHrelated topics and PC using cultural sensitivity; 8) importance of being ready/temporality/planning for the future; 9) the importance of family-centered care; and 10) variation in educational tailoring and dissemination/ care delivery.
Conclusions: Findings support the need for culturally sensitive and developmentally appropriate PC programs to empower adolescent Latinas with DM.
Keywords: Preconception counseling, adolescents, diabetes, Latinas, reproductive health