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Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial

PURPOSE: Open-source automated insulin delivery (AID) is used by thousands of people with type 1 diabetes (T1D), but has unknown generalisability to marginalised ethnic groups. This study explored experiences of Indigenous Māori participants in the CREATE trial with use of an open-source AID system...

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Autores principales: Burnside, Mercedes, Haitana, Tracy, Crocket, Hamish, Lewis, Dana, Meier, Renee, Sanders, Olivia, Jefferies, Craig, Faherty, Ann, Paul, Ryan, Lever, Claire, Price, Sarah, Frewen, Carla, Jones, Shirley, Gunn, Tim, Wheeler, Benjamin J., Pitama, Suzanne, de Bock, Martin, Lacey, Cameron
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035484/
https://www.ncbi.nlm.nih.gov/pubmed/37250371
http://dx.doi.org/10.1007/s40200-023-01215-3
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author Burnside, Mercedes
Haitana, Tracy
Crocket, Hamish
Lewis, Dana
Meier, Renee
Sanders, Olivia
Jefferies, Craig
Faherty, Ann
Paul, Ryan
Lever, Claire
Price, Sarah
Frewen, Carla
Jones, Shirley
Gunn, Tim
Wheeler, Benjamin J.
Pitama, Suzanne
de Bock, Martin
Lacey, Cameron
author_facet Burnside, Mercedes
Haitana, Tracy
Crocket, Hamish
Lewis, Dana
Meier, Renee
Sanders, Olivia
Jefferies, Craig
Faherty, Ann
Paul, Ryan
Lever, Claire
Price, Sarah
Frewen, Carla
Jones, Shirley
Gunn, Tim
Wheeler, Benjamin J.
Pitama, Suzanne
de Bock, Martin
Lacey, Cameron
author_sort Burnside, Mercedes
collection PubMed
description PURPOSE: Open-source automated insulin delivery (AID) is used by thousands of people with type 1 diabetes (T1D), but has unknown generalisability to marginalised ethnic groups. This study explored experiences of Indigenous Māori participants in the CREATE trial with use of an open-source AID system to identify enablers/barriers to health equity. METHODS: The CREATE randomised trial compared open-source AID (OpenAPS algorithm on an Android phone with a Bluetooth-connected pump) to sensor-augmented pump therapy. Kaupapa Māori Research methodology was used in this sub-study. Ten semi-structured interviews with Māori participants (5 children, 5 adults) and whānau (extended family) were completed. Interviews were recorded and transcribed, and data were analysed thematically. NVivo was used for descriptive and pattern coding. RESULTS: Enablers/barriers to equity aligned with four themes: access (to diabetes technologies), training/support, operation (of open-source AID), and outcomes. Participants described a sense of empowerment, and improved quality of life, wellbeing, and glycaemia. Parents felt reassured by the system’s ability to control glucose, and children were granted greater independence. Participants were able to use the open-source AID system with ease to suit whānau needs, and technical problems were manageable with healthcare professional support. All participants identified structures in the health system precluding equitable utilisation of diabetes technologies for Māori. CONCLUSION: Māori experienced open-source AID positively, and aspired to use this therapy; however, structural and socio-economic barriers to equity were identified. This research proposes strength-based solutions which should be considered in the redesign of diabetes services to improve health outcomes for Māori with T1D. Trial Registration: The CREATE trial, encompassing this qualitative sub-study, was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000034932p) on the 20(th) January 2020. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-023-01215-3.
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spelling pubmed-100354842023-03-23 Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial Burnside, Mercedes Haitana, Tracy Crocket, Hamish Lewis, Dana Meier, Renee Sanders, Olivia Jefferies, Craig Faherty, Ann Paul, Ryan Lever, Claire Price, Sarah Frewen, Carla Jones, Shirley Gunn, Tim Wheeler, Benjamin J. Pitama, Suzanne de Bock, Martin Lacey, Cameron J Diabetes Metab Disord Research Article PURPOSE: Open-source automated insulin delivery (AID) is used by thousands of people with type 1 diabetes (T1D), but has unknown generalisability to marginalised ethnic groups. This study explored experiences of Indigenous Māori participants in the CREATE trial with use of an open-source AID system to identify enablers/barriers to health equity. METHODS: The CREATE randomised trial compared open-source AID (OpenAPS algorithm on an Android phone with a Bluetooth-connected pump) to sensor-augmented pump therapy. Kaupapa Māori Research methodology was used in this sub-study. Ten semi-structured interviews with Māori participants (5 children, 5 adults) and whānau (extended family) were completed. Interviews were recorded and transcribed, and data were analysed thematically. NVivo was used for descriptive and pattern coding. RESULTS: Enablers/barriers to equity aligned with four themes: access (to diabetes technologies), training/support, operation (of open-source AID), and outcomes. Participants described a sense of empowerment, and improved quality of life, wellbeing, and glycaemia. Parents felt reassured by the system’s ability to control glucose, and children were granted greater independence. Participants were able to use the open-source AID system with ease to suit whānau needs, and technical problems were manageable with healthcare professional support. All participants identified structures in the health system precluding equitable utilisation of diabetes technologies for Māori. CONCLUSION: Māori experienced open-source AID positively, and aspired to use this therapy; however, structural and socio-economic barriers to equity were identified. This research proposes strength-based solutions which should be considered in the redesign of diabetes services to improve health outcomes for Māori with T1D. Trial Registration: The CREATE trial, encompassing this qualitative sub-study, was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000034932p) on the 20(th) January 2020. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-023-01215-3. Springer International Publishing 2023-03-23 /pmc/articles/PMC10035484/ /pubmed/37250371 http://dx.doi.org/10.1007/s40200-023-01215-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Burnside, Mercedes
Haitana, Tracy
Crocket, Hamish
Lewis, Dana
Meier, Renee
Sanders, Olivia
Jefferies, Craig
Faherty, Ann
Paul, Ryan
Lever, Claire
Price, Sarah
Frewen, Carla
Jones, Shirley
Gunn, Tim
Wheeler, Benjamin J.
Pitama, Suzanne
de Bock, Martin
Lacey, Cameron
Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial
title Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial
title_full Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial
title_fullStr Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial
title_full_unstemmed Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial
title_short Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial
title_sort interviews with indigenous māori with type 1 diabetes using open-source automated insulin delivery in the create randomised trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035484/
https://www.ncbi.nlm.nih.gov/pubmed/37250371
http://dx.doi.org/10.1007/s40200-023-01215-3
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