Latino Youth with Diabetes: A Mixed Methods Examination of Adherence and Metabolic Control within the Context of Sociopolitical and Policy Challenges

The current study employed quantitative and qualitative methods to examine predictors of adherence and diabetes health outcomes in Latino youth, and to gain understanding of mechanisms that underlie health behaviors and outcomes. Forty-nine Latino youth and their caregivers were recruited at a hospital-based outpatient diabetes clinic, 76% of the youth were either first or second-generation Latino youth (i.e., immigrant youth or youth whose parents are immigrants). A primary aim of this study was to quantitatively examine the impact of parent immigrant-related stress on child health behaviors and outcomes. This study complements these quantitative analyses by qualitatively exploring how (e.g., under what conditions) pathways to health are created. Specifically, qualitative analyses examined the unique experiences of Latino immigrant families in managing adherence to treatment and metabolic control, and gain insight into specific health promoters and barriers. Further, the author intended to qualitatively explain the effects of recently enacted immigration laws on Latino youths’ health behaviors and outcomes. Results revealed that higher levels of fear of deportation predict lower child-reported adherence, β = -41, p < .05. Higher levels of caregiver immigrant stress predict higher BMI rates in children, β = .30, p < .05. Immigrant related stressors, including fear of deportation, did not predict A1c or diabetes ketoacidosis (DKA) hospitalizations in the last year. Qualitative results highlight themes related to direct and indirect barriers to health behaviors and outcomes for youth, as well as ethnocultural promoters of coping and resilience. INDEX WORDS: Latino, Youth, Diabetes, Adherence, Immigration laws, Health disparities LATINO YOUTH WITH DIABETES: A MIXED METHODS EXAMINATION OF ADHERENCE AND METABOLIC CONTROL WITHIN THE CONTEXT OF SOCIOPOLITICAL AND POLICY