P-366: Cultural humility and equity in early type 1 diabetes recognition
C Baez-Smith, C Baez-SmithAbstract
Introduction
Hispanic and Black youth remain at risk for inequitable early recognition of type 1 diabetes (T1D), including delayed testing, referral, and diabetic ketoacidosis (DKA) at diagnosis. Although early-stage T1D screening is expanding, less attention has focused on communication, trust, language, and bias-related factors that influence whether symptoms are recognized and escalated.
Objectives
To examine how cultural humility has been applied to early T1D recognition among Hispanic and Black children and adolescents and develop a theory-guided model for culturally responsive detection.
Methods
A PRISMA-informed gap review and conceptual synthesis were conducted across pediatric diabetes, cultural humility, health equity, diagnostic disparity, and nursing literature. Walker and Avant’s method clarified cultural humility. Leininger’s Culture Care Theory and Campinha-Bacote’s model organized a conceptual-theoretical-empirical model linking cultural humility to early T1D recognition.
Results
No studies directly tested cultural humility as an intervention to improve early T1D detection among Hispanic and Black pediatric populations. Related literature showed persistent DKA-at-diagnosis disparities, limited culturally responsive communication in T1D screening pathways, and insufficient race/ethnicity-stratified reporting. The model links cultural humility to caregiver narrative elicitation, language-concordant education, trust, symptom interpretation, referral timing, autoantibody testing, CGM metrics, DKA prevention, stage 2 identification, stage 3 progression, and therapy eligibility.
Conclusions
Cultural humility may be an underdeveloped mechanism for improving equity in early T1D recognition. Future studies should test culturally responsive recognition pathways with outcomes stratified by race, ethnicity, language preference, referral completion, DKA at diagnosis, and T1D stage.