On the money: Parental perspectives about finances and type 1 diabetes in youth

Authors: ESHTEHARDI, SAHAR - Baylor College Of Medicine; ANDERSON, BARBARA - Baylor College Of Medicine; CAO, VIENA - Baylor College Of Medicine; MCKINNEY, BRETT - Indiana University; Thompson, Deborah - Debbe; MARRERO, DAVID - University Of Arizona; HILLIARD, MARISA - Baylor College Of Medicine

Submitted to: Clinical Practice in Pediatric Psychology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/30/2020
Publication Date: 9/21/2020
Citation: Eshtehardi, S.S., Anderson, B.J., Cao, V.T., McKinney, B.M., Thompson, D.J., Marrero, D.G., Hilliard, M.E. 2020. On the money: Parental perspectives about finances and type 1 diabetes in youth. Clinical Practice in Pediatric Psychology. https://doi.org/10.1037/cpp0000371.
DOI: https://doi.org/10.1037/cpp0000371

Interpretive Summary: Diabetes care is expensive and may be a source of stress for parents whose child has type 1 diabetes. Understanding parent perspectives on diabetes-related costs and potential impact on quality of life may provide important insights for health care professionals working with these families. Interviews with parents of children with type 1 diabetes revealed that diabetes care costs were often prioritized over other needs such as family vacations, and that that employment choices were impacted by salary and benefits such as insurance coverage. Parents expressed gratitude and were thankful for employment and insurance coverage that defrayed the costs of diabetes care. This work provides suggestive evidence that health care providers should consider the financial costs of diabetes care when working with families who have a child with type 1 diabetes.

Technical Abstract: Given the costs of diabetes care, finances may be a source of stress for parents of youth with type 1 diabetes. The purpose of this study was to characterize the perspectives of parents of youth with type 1 diabetes about diabetes-related expenses and any potential relationship with quality of life. Parents (n=23, 96% mothers) of youth with type 1 diabetes (aged 5–17 years; 35% female, mean HbA1c=8.7%) each completed a semistructured qualitative interview. Verbatim transcripts were coded using thematic analysis to derive central themes related to diabetes-related finances. Two primary themes emerged: (a) sacrifices and hardships—Parents described making decisions about household finances to accommodate diabetes-related expenses and employment choices based on salary and benefits; many described prioritizing spending for diabetes supplies, healthy foods, and medical bills and forgoing spending related to family vacations, recreation, and personal needs; and (b) gratitude—Parents discussed feeling thankful for employment and insurance coverage, which help reduce diabetes-related financial stressors or hardships. Care of families of youth with type 1 diabetes should consider parents' financial experiences and effects on family. Routinely asking about diabetes-specific financial issues in relation to family stress and coping may help inform behavioral and medical care and can facilitate referrals to social work.