"I Think Parents Shouldn't Be Too Pushy": A Qualitative Exploration of Parent and Youth Perspectives of Youth Decision-Making Involvement in Starting Continuous Glucose Monitoring.
Ettya R Fremont, Nathalie Slick, Steven M Willi and 1 others
PMID 34448420WHAT IT FOUND
Families described four ways youth decided to start CGM, from youth-led to parent-led without agreement.
Ask youth directly, give balanced information, and let them handle the device.
Key findings
01Youth were sorted into four decision-making roles: youth primary decision maker (23, 54.8%), youth primary decision maker with parental influence (6, 14.3%), parent primary decision maker with youth agreement (11, 26.2%), and parent primary decision maker without youth agreement (2, 4.8%).
02Participants suggested enhancing youth involvement by making CGM the youth's decision, encouraging youth to speak up and ask questions, giving unbiased information, and using visual aids, device handling, or trial runs.
03Provider behaviors described included giving information, recommending CGM, offering logistical and emotional support, and sharing their own CGM use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was predominantly non-Hispanic white, from the Northeast, and most parents were mothers, so it may not reflect other families or father-led decisions. Only one brand of CGM was used, so the findings may not apply to other CGM devices. Follow-up interviews were about two months after device initiation, so there are no data on longer-term use or decisions over time. Providers were not interviewed, so their perspective on the decision-making process is missing. Families who decided not to pursue CGM were not included, so the study does not describe why some families refused. Not all selected dyads completed interviews: 40 parents and 41 youth completed baseline interviews, and 41 parents and 43 youth completed follow-up interviews.
Declared interests
The authors reported no potential conflicts of interest relevant to this study. The article is listed as NIH extramural research support.
The easy way to misread this
Do not read these themes as evidence that youth-led decision-making improves diabetes control or CGM use. The study described how families approached the decision, and roles did not vary by A1C or days of CGM use.