P-67: Systemic barriers to inclusive education for children with T1D in Mexico: qualitative findings from the escuela T1D study
E L Picasso Rivera, E Sainz de la Maza, A Miranda Lora, B E MarksAbstract
Introduction
Access to safe, inclusive education is a fundamental right for children with type 1 diabetes (T1D) regardless of where they live. Although Mexican law protects these rights, children with T1D continue to have many unmet needs.
Objectives
We aimed to identify systemic barriers to accessing education among youth with T1D in Mexico City.
Methods
This qualitative study is part of a broader research protocol (ESCUELA T1D) seeking to adapt existing diabetes management plans for use in Mexico. Five semi-structured focus groups were conducted with key stakeholders involved in the care of children attending primary school. All sessions were conducted in Spanish and were audio-recorded, transcribed (Durationmedian:100min), and double-coded by two independent coders. Modified inductive coding was used for thematic analysis. Thematic saturation was achieved.
Results
Focus group participants included: parents (n=12; Female=100%, Agechild=9.5yrs, range:7-12yrs, 50% public school), teachers (n=7), school health personnel (n=7), and pediatric endocrinologists (n=7). Three themes emerged (Fig.1): Theme 1: Lack of trained health care personnel and the absence of protocols for T1D management in the school environment. Theme 2: Restricted access to supplies prevents students from engaging in T1D self-care behaviors. Theme 3: Without institutional policies families are forced to rely on the goodwill of school staff for T1D care.
Conclusions
Systemic barriers and lack of awareness of legal protections prevent children with T1D from participating in safe, inclusive education in Mexico. Existing diabetes management plans and training programs must be adapted to address the unique challenges within the Mexican system.