Patterns of social participation among older adults with disabilities and the relationship with well-being: A latent class analysis

AimLiving with a chronic condition or a disability at older age impacts social participation. Social connections and social activities seem interrelated leading to heterogeneous patterns in social participation. The aim of this study was to identify a typology in social participation among older adults with disabilities, and to relate this typology to their background characteristics and well-being measures.MethodsA total of 1775 older adults with disabilities or chronic conditions aged 65–97 were sampled from a nationwide panel study in the Netherlands. Social participation was assessed by various measures related to social connections, social informal activities, voluntary work, effort to increase social participation, and online social participation. A latent class analysis was carried out to identify a typology of social participation. Differences between these classes were explored with multinomial regression analyses and pairwise comparisons.ResultsFour classes were found: social withdrawers (22.5%, n = 399), proximate social dwellers (14.5%, n = 257), moderately active social dwellers (37.2%, n = 660) and pro-active social dwellers (25.9%, n = 459). Background characteristics, such as living alone and severity of disability, differed significantly among classes. Regarding well-being measures, it appeared that pro-active social dwellers had the most positive scores. Social withdrawers were most prone to reduced life satisfaction and health related quality of life and increased loneliness and experienced participation restrictions.ConclusionsA typology with four patterns based on a wide spectrum of social participation aspects in older adults with disabilities was identified. This typology may help to assess the risk for reduced well-being of older adults with disabilities.     

Diabetes multimorbidity combinations and disability in the Mexican Health and Aging Study, 2012–2015

PurposeThe aim of this study was to investigate the relationship between specific combinations of chronic conditions and disability in Mexican older adults with diabetes.MethodsThis was a prospective cohort study of Mexican adults (n = 2558) with diabetes and aged 51 or older that used data from the 2012 and 2015 waves of the Mexican Health and Aging Study. The main outcome was an index that measured ability to perform activities of daily living and instrumental activities of daily living. The main independent variables were diabetes multimorbidity combinations, defined as diabetes and at least one other chronic condition. The authors calculated the prevalence of each multimorbidity combination present in the sample in 2012 and used negative binomial regression models to estimate the association of the most prevalent of these combinations with disability incidence in 2015.ResultsThe three most prevalent combinations were: 1) diabetes-hypertension (n = 637, 31.9%) 2) diabetes-hypertension-depression (n = 388, 19.4%) and 3) diabetes-depression (n = 211, 10.6%). In fully adjusted models comparing participants with specific multimorbidity combinations to participants with diabetes alone, the combinations that had an increased association with disability were diabetes-hypertension-depression, diabetes-depression and diabetes-hypertension-arthritis-depression. In nested models, the addition of arthritis to combinations including depression increased this association.ConclusionsConsistent with prior studies, multimorbidity combinations including depression were associated with increased risk of disability. However, the effect size of this relationship was lower than what had been previously been reported internationally. This highlights the need for globally oriented multimorbidity research.     

A mixed methods study describing the self-care practices in an older working population with cardiovascular disease (CVD): Balancing work,life and health

BackgroundSelf-care is essential to cardiovascular disease (CVD) health outcomes, but may be challenging for older working adults.ObjectiveDescribe self-care and the relationship of work-related characteristics to self-care among older workers with CVD.MethodsConvergent mixed methods design (n = 108) assessed self-care, organization of work, job-level and clinical factors; qualitative data (n = 40) explored self-care and working. Data integrated in the final analytic phase.ResultsSixty-eight percent reported adequate self-care maintenance (SC-CHDI maintenance ≥70); only 22% had adequate self-care management (SC-CHDI management ≥ 70). Controlling for physical capacity, work-related factors explained 22% variance in self-care maintenance; physical capacity was only significant determinant of self-care management. Individuals with poor self-care described low job control, job stress and work-life imbalance that interfered with routine self-care. Individuals with poor self-care management reported “feeling stressed out” and “extreme fatigue” attributed to their job.ConclusionsInterventions targeting self-care, stress management and work-life balance among older workers with CVD are needed.     

Combined effects of frailty status and cognitive impairment on health-related quality of life among community dwelling older adults

ObjectivesThe aim of the present study was to investigate the combined association of frailty/pre-frailty and cognitive impairment with health related quality of life (HRQOL) among community dwelling older adults.MethodsData came from a cross-sectional study of community-dwelling older adults aged 65 years or older, who participated in the 2013 National Health Interview Survey in Taiwan. Frailty was determined based on the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale proposed by the International Association of Nutrition and Aging. The Mini-Mental State Examination was used to assess cognitive function. HRQOL was measured using the European Quality of Life-5 Dimensions questionnaire (EQ-5D) that assesses three levels of functioning for the dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Poisson regression models were performed to estimate prevalence ratios (PR) and 95 % Confidence Intervals (95 % CI) for health problems in all EQ-5D domains.ResultsIn this study, 11.0 % of participants aged 65 years and older had co-occurring frailty/pre-frailty and cognitive impairment. After adjustment for other factors, compared with participants who were physically robust with normal cognition, participants with co-occurring frailty/pre-frailty and cognitive impairment had PRs of 10.38 (95 % CI 7.56–14.26), 9.66 (95 % CI 6.03–15.48), 9.37 (95 % CI 6.92–12.68), 3.04 (95 % CI 2.53–3.64), and 5.63 (95 % CI 3.83–8.28) for reporting problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, respectively.ConclusionsThere is a high prevalence of co-occurrence of frailty/pre-frailty and cognitive impairment in older adults, and this co-occurrence was strongly associated with self-reported health problems across all EQ-5D domains.     

Impacts of the COVID-19 pandemic on unmet social needs,self-care,and outcomes among people with diabetes and poor glycemic control

AimsThe purpose of this study was to examine whether pandemic exposure impacted unmet social and diabetes needs, self-care behaviors, and diabetes outcomes in a sample with diabetes and poor glycemic control.MethodsThis was a cross-sectional analysis of participants with diabetes and poor glycemic control in an ongoing trial (n = 353). We compared the prevalence of unmet needs, self-care behaviors, and diabetes outcomes in successive cohorts of enrollees surveyed pre-pandemic (prior to March 11, 2020, n = 182), in the early stages of the pandemic (May–September, 2020, n = 75), and later (September 2020–January 2021, n = 96) stratified by income and gender. Adjusted multivariable regression models were used to examine trends.ResultsMore participants with low income reported food insecurity (70% vs. 83%, p < 0.05) and needs related to access to blood glucose supplies (19% vs. 67%, p < 0.05) during the pandemic compared to pre-pandemic levels. In adjusted models among people with low incomes, the odds of housing insecurity increased among participants during the early pandemic months compared with participants pre-pandemic (OR 20.2 [95% CI 2.8–145.2], p < 0.01). A1c levels were better among participants later in the pandemic than those pre-pandemic (β = ?1.1 [95% CI ?1.8 to ?0.4], p < 0.01), but systolic blood pressure control was substantially worse (β = 11.5 [95% CI 4.2–18.8, p < 0.001).ConclusionAdults with low-incomes and diabetes were most impacted by the pandemic. A1c may not fully capture challenges that people with diabetes are facing to manage their condition; systolic blood pressures may have worsened and problems with self-care may forebode longer-term challenges in diabetes control.     

Sociodemographic characteristics associated with self-care and quality of life among community-dwelling older adults with type 2 diabetes

AimsTo assess how well community-dwelling older adults in Singapore were coping with their diabetes, and the sociodemographic characteristics that were associated with their level of coping.MethodsThis was a cross-sectional study involving 257 older adults. Multiple regression was used to assess the associations between various sociodemographic characteristics and coping measures of present quality of life and level of self-care.ResultsOlder adults mainly sought care in the primary care setting. They were not coping well given their mean scores for diabetes-dependent quality of life and the self-care index were ?3.57 and 3.55 respectively. Compared to those with post-secondary education, individuals who had no formal (adjusted B ?0.92, p 0.003), primary level (adjusted B ?0.76, p < 0.001) and secondary level (adjusted B ?0.50, p < 0.02) education reported lower present quality of life. Those with prior lowest skill level occupations were less likely to consume a healthy diet per week than those with prior highest skill level occupations (adjusted B ?1.48, p 0.004).ConclusionsThere should be provision of diabetes self-care interventions targeting older adults in Singapore especially for those with lower education and work skill levels. As the first line of contacts, primary care providers should advocate for diabetes self-care and develop community-based interventions for these priority groups.     

Internet use among primary care patients with type 2 diabetes

BACKGROUND: The Internet represents a promising tool to improve diabetes care. OBJECTIVE: To assess differences in demographics, self-care behaviors, and diabetes-related risk factor control by frequency of Internet use. DESIGN AND PARTICIPANTS: We surveyed 909 patients with type 2 diabetes attending primary care clinics. MEASUREMENTS: Frequency of Internet use, socioeconomic status, and responses to the Problem Areas in Diabetes (PAID), Summary of Diabetes Self-care Activities (SDSCA), and Health Utilities Index (HUI) scales. Survey responses were linked to last measured hemoglobin A1c, cholesterol, and blood pressure results. Comorbidities and current medications were obtained from the medical record. RESULTS: Internet "never-users" (n=588, 66%) were significantly older (70.0+/-11.2 vs 59.0+/-11.3 years; P<.001) and less educated (26% vs 71% with>high school; P<.001) than Internet users (n=308, 34%). There were few significant differences in PAID or SDSCA scores or in diabetes metabolic control despite longer diabetes duration (10.3+/-8.2 vs 8.3+/-6.7 years; P<.001) and greater prevalence of coronary disease (40% vs 24%; P<.001) in nonusers. Less than 10% of current nonusers would use the Internet for secure health-related communication. CONCLUSIONS: Older and less educated diabetes patients are less likely to use the Internet. Despite greater comorbidity, nonusers engaged in primary care had equal or better risk factor control compared to users.     

Association between mental health and self-care behavior among older adults with diabetes according to Behavioral Risk Factor Surveillance System 2019

AimTo assess the association of mental health burden with diabetes-related self-care behaviors and healthcare utilization among older adults.MethodThis cross-sectional 2019 Behavioral Risk Factor Surveillance System (BRFSS) study included ≥ 65 years old adults with self-reported diabetes. Three groups were used based on the number of days in the past month affected by mental health: 0 days (no burden), 1–13 days (occasional burden), and 14–30 days (frequent burden). Primary outcome was performing ≥ 3 of 5 diabetes-related self-care behaviors. Secondary outcome was performing ≥ 3 of 5 healthcare utilization behaviors. Multivariable logistic regression was used in Stata/SE 15.1.ResultsOf 14,217 included individuals, 10.2 % reported frequent mental health burden. Compared to ‘no burden’, ‘occasional’ and ‘frequent burden’ groups included more female, obese, not married persons with younger age of diabetes diagnosis, and reported more comorbidities, insulin use, cost-related barriers to see doctors, and diabetes-related eye issues (p < 0.05). ’Occasional/frequent burden’ groups reported less self-care and healthcare utilization behaviors, except 30 % higher healthcare utilization was observed in the ‘occasional burden’ group compared to no burden (aOR 1.30, 95 %CI 1.08–1.58, p = 0.006).ConclusionsOverall, mental health burden was associated with reduced participation in diabetes-related self-care and healthcare utilization behaviors in a stepwise manner, except occasional burden was associated with higher healthcare utilization.     

Depression prevalence and treatment among older home health services users in the United States

ObjectiveThe purpose of this study is to provide a nationally representative estimate of the rates of depression and depression treatment, and to explore factors associated with receipt of depression treatment, among older home health services users.MethodsOlder home health services users (n = 1666) were selected from 2008 to 2013 Medical Expenditure Panel Survey. Depression was measured by the Patient Health Questionnaire-2. Depression treatment included antidepressants use and receipt of mental health counseling or psychotherapy. Logistic regression was used to examine the association of individual characteristics and receipt of depression treatment.ResultsCurrent depression affected 23% of older home health services users. Less than 40% of those who screened positive for depression reported receiving depression treatment. Among those who received treatment, virtually all (99.8%) reported receiving antidepressants and only 9.5% reported receiving psychotherapy. Among older home health services users with current depression, older age and non-Hispanic black race were associated with lower odds of receiving depression treatment whereas having cognitive impairment was positively associated with receiving depression treatment.ConclusionDepression affects a substantial proportion of older home health services users and is undertreated. Home health services settings may be important platforms to improve depression care among older adults. Future research is needed to develop optimal strategies for integrating depression assessment and treatment in home health services settings.     

Depressive symptoms mediate the relationship between diabetes and cognitive performance in a community-based sample of older adults

AimsTo evaluate whether diabetes and prediabetes are associated with impaired cognitive performance among older adults and examine depressive symptoms as a mediator.MethodsWe used cross-sectional data from the Einstein Aging Study, a systematically recruited, community-based cohort study of diverse older adults (N = 794; Age Mean (SD) = 78.9 (5.3); 64.4% Non-Hispanic White, 28.7% Non-Hispanic Black, 5.7% Hispanic). Diabetes status was established via self-reported diagnosis, prescribed medications, and fasting blood glucose. Depressive symptoms were assessed using the Geriatric Depression Scale. Cognitive tests included Digit Symbol, Trails-B, Free Recall, Category Fluency, Boston Naming, and Block Design. Linear regression and mediation analyses were applied.ResultsCompared to those without diabetes, diabetes was associated with worse performance on all cognitive tests (ps < 0.05), except Trails-B (p = 0.53), and increased depressive symptoms (p < 0.01). For diabetes, mediation via increased depressive symptoms was observed for Free Recall (p = 0.044), Category Fluency (p = 0.033), and Boston Naming (p = 0.048).ConclusionsDiabetes was consistently associated with worse cognitive performance and increased depressive symptoms among this older cohort, while prediabetes was not. Mediation findings suggest depressive symptoms may be a biobehavioral pathway linking diabetes and cognition, though the temporal sequence is unclear. If causal, addressing both diabetes and depressive symptoms among older adults may protect cognitive function.     

Multidimensional prognostic index (MPI) predicts non-invasive ventilation failure in older adults with acute respiratory failure

BackgroundAcute respiratory failure (ARF) is a very common complication among hospitalized older adults. Non-invasive ventilation (NIV) may avoid admission to intensive care units, intubation and their related complication, but still lacks specific indications in older adults. Multidimensional Prognostic Index (MPI) based on comprehensive geriatric assessment (CGA) could have a role in defining the short-term prognosis and the best candidates for NIV among older adults with ARF.MethodsThis is a retrospective observational study which enrolled patients older than 70 years, consecutively admitted to an acute geriatric unit with ARF. A standardized CGA was used to calculate the MPI at admission. Multivariate Cox regression models were used to test if MPI score could predict in-hospital mortality and NIV failure. Receiver operator curve (ROC) analysis was used to identify the discriminatory power of MPI for NIV failure.ResultsWe enrolled 231 patients (88.2 ± 5.9 years, 47% females). Mean MPI at admission was 0.76±0.16. In-hospital mortality rate was 33.8%, with similar incidence in patients treated with and without NIV. Among NIV users (26.4%), NIV failure occurred in 39.3%. Higher MPI scores at admission significantly predicted in-hospital mortality (β=4.46, p<0.0001) among patients with ARF and NIV failure (β=7.82, p = 0.001) among NIV users. MPI showed good discriminatory power for NIV failure (area under the curve: 0.72, 95% CI: 0.58–0.85, p<0.001) with optimal cut-off at MPI value of 0.84.ConclusionsMPI at admission might be a useful tool to early detect patients more at risk of in-hospital death and NIV failure among older adults with ARF.     

Neighborhood Social Cohesion,Physical Disorder,and Daily Activity Limitations Among Community-Dwelling Older Adults

IntroductionAlthough extensive factors have been examined for limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), it remains unclear as to the impacts of neighborhood-level factors on ADL and IADL limitations. Thus, we aim to examine whether neighborhood characteristics are predictive of limitations in ADL and IADL.MethodsA total of 7,407 participants were selected from the National Health and Aging Trend Study. We used data from round 1 (2011) to round 8 (2018). Neighborhood characteristics were measured as social cohesion and physical disorder. Daily activity limitations were counted based on the domains of ADL and IADL. Mixed-effects negative binomial regression analyses were performed to estimate the effects of neighborhood features on ADL and IADL limitations.ResultsBetter neighborhood social cohesion significantly predicted less limitations in ADL (incidence rate ratio [IRR] = 0.98, 95% confidence interval [CI] = 0.96 - 0.99) and IADL (IRR=0.96, 95% CI = 0.95 - 0.98). More physical disorder predicted more IADL limitations (IRR=1.04, 95% CI = 1.01 - 1.06), but was not associated with ADL limitations.ConclusionNeighborhood social cohesion is essential in enabling older adults to perform both basic self-care activities and more complex tasks, while neighborhood physical disorder is significant to older adults’ capability in performing more complex sets of activities so as to age in place. The study findings underscore the importance of improving both social and physical aspects of neighborhood environment to facilitate older adults’ daily activity performance.     

Effect of a community-based intervention on self-care among diabetes patients in rural Tamil Nadu: A mixed-method study

IntroductionPeer support models for the management of diabetes self-care have been hailed as a promising solution to strengthen a formal health system to support diabetes patients. Diabetes self-care in patients can truncate the risk factors and reduce the complications.ObjectiveTo identify self-care level (adherence to the diet, exercise, treatment) and depression among known diabetes patients and to find the effect of the support group intervention on diabetes self-care.Methods and materialA Sequential type Embedded Mixed-Method study (qual→QUAN(qual)→qual) was conducted in three phases in 168 known diabetes adults aged ≥ 30 years in a rural setting. After obtaining IEC clearance, the intervention was carried out over eight months, forming peer support groups in four villages. Each group comprises between six to 12 participants. Assessment of self-care, treatment adherence and depression with standardized scales.Data analysisA manual content analysis was performed on the qualitative data. The Wilcoxon rank test was used to compare the quantitative data before and after intervention and analyzed using SPSS (Version_24) software package.ResultsIn this study, we found improved self-care practices and treatment adherence among study participants (p < 0.001). About 88.7% of participants said that the support group was useful and provided moral support for diabetes.ConclusionWe found an improvement in treatment adherence, self-care among diabetes patients’ and marginal improvement in depression status through support group intervention. Also the peer support group was well accepted, and it provided the low-cost, feasible intervention respect to the chronic conditions like diabetes, by addressing their behavioral changes and support from community. By sustaining the support group, might able to achieve the efficient health care in high quality even at resource-poor settings.Key messagesA Community-Based intervention for the diabetes self-care using peer support group among the diabetes patients will improve the self-care practices in the area with limited access to healthcare and financial resources, it provides a low-cost, flexible, culturally sensitive approach to support self-care management and reduce the further complications among It also imporve the problem-solving capacity and social support from families and peers patients.     

An assessment of self-care knowledge among patients with diabetes mellitus

PurposesThis study aimed to (1) assess the level of diabetes self-care knowledge among patients with diabetes mellitus and (2) examine the relationship between patients' diabetes self-care knowledge and their demographic and medical characteristics.MethodsA cross-sectional design was used to implement the study. A convenience sample of 273 diabetic patients were recruited from five primary health-care centers in Amman- Jordan.ResultsThe overall level of knowledge of diabetes self-care in the total sample was moderate (58.28% (SD = 18.24)). The highest level of knowledge was meal planning (70.2%) followed by monitoring, causes of diabetes, foot care, symptoms and complication, diabetic medication, and the lowest level was exercise (42.5%). Furthermore, knowledge of diabetes self-care was found to be associated with age, educational status, diabetic medications and years with diabetes.Conclusionand Practice implications: The study findings emphasized that diabetic patients had a moderate level of knowledge and there were many of the learning needs for each area of knowledge. The health-care professional has an important role in developing the appropriate diabetes educational programs based on patients' learning needs and patients' characteristics. These programs that enhances knowledge on diabetes could be reduced or prevented diabetes-related complications.     

Variability between self-reported diabetes and measured glucose among health screening participants in South Central Kentucky

AimsTo assess self-reported diabetes and random glucose among health screening participants and examine factors associated with these two diabetes outcomes.MethodsStudy subjects were adults aged ≥18 years who participated in diabetes screenings via a mobile health clinic operated by the Institute for Rural Health at Western Kentucky University from 2006 to 2011. Data on self-reported diabetes were based on physicians’ past diagnosis. Random plasma glucose was obtained during the screenings. Non-fasting plasma glucose levels of ≥180 mg/dl and ≥140 mg/dl were used as cutoffs to determine diabetes and diabetes or pre-diabetes, respectively. Logistic regression was used to examine factors associated with self-reported diabetes and elevated non-fasting glucose levels controlling for comorbidities and sociodemographic factors.ResultsThe proportion of self-reported diabetes was 9.6%. The proportion of participants with ≥180 mg/dl was 3.2% and that with ≥140 mg/dl was 7.4%. Odds ratios indicated that self-reported diabetes was higher in older and obese groups and those who had hypertension and hypercholesterolemia and family history of diabetes, while elevated non-fasting glucose levels were higher among participants without health insurance and those who reported they had diabetes.ConclusionsVariability in risks between self-reported diabetes and measured glucose should be incorporated in diabetes self-care.     

Tobacco use patterns and clinical outcomes in the T1D exchange

AimsThis study examined associations between tobacco use and diabetes outcomes using the T1D Exchange Registry.MethodsAdult participants (N = 933) completed standardized questionnaires including self-reported outcomes: past year serious hypoglycemic and diabetic ketoacidosis episodes, diabetes self-care, diabetes distress, and self-monitoring of blood glucose. Chart-extracted outcomes included HbA1c, nephrology and neuropathy diagnoses, and BMI. We examined the relation of tobacco use status (never, former, current) and frequency of use (daily versus less than daily) to these outcomes.ResultsThe majority had never used tobacco (55%, n = 515); 27% (n = 252) were former users and 18% (n = 166) were current users (with 31% using daily). Tobacco status was associated with HbA1c, BMI, self-care, distress, and blood glucose monitoring frequency. Across most outcomes, current users evidenced worse values relative to never users, and former users were largely similar to never users. Daily use was associated with significantly worse outcomes on HbA1c, diabetes self-care, and distress scores relative to less than daily use.ConclusionsThese cross-sectional comparisons suggest that current tobacco use is associated with worse status on important clinical diabetes indicators. Former users did not evidence these deleterious associations. Findings point to potential diabetes-specific motivators that could inform tobacco cessation interventions.     

Level of active aging: Influence of environmental,social and health-related factors

ObjectiveTo analyze social, environmental and health-related inequalities in the level of active aging among older adults who participated in the Health Survey conducted in the city of Campinas, Brazil.MethodsThe level of active aging was estimated based on a ranking of engagement in activities using factor analysis. More active older adults (situated in the highest tertile of the ranking) were compared with the others through the prevalence ratios (PR) and respective 95 % confidence intervals (CI) estimated by Poisson regression.ResultsThe study population thus consisted of 986 older adults. The majority of the respondents were female (57.6 %), in the 60–69 years age group (56.7 %), had less than 8 years of schooling (65.3 %) and had a per capita family income of 1–3 minimum salaries (55.3 %). Access to public spaces for the practice of physical activity near the home (PR = 1.44; 95 % CI, 1.07−1.94) and higher level of education (PR = 2.14; 95 % CI, 1.60−2.86), income (PR = 1.73; 95 % CI, 1.25−2.40), physical health (PR = 1.44; 95 % CI, 1.13−1.82) and mental health (PR = 1.62; 95 % CI, 1.05−2.49) were more prevalent among older adults with a high level of active aging.DiscussionThe findings demonstrate that the level of involvement in activities does not solely depend on personal choices. Social, economic, environmental, physical and mental contexts all exert a strong influence.     

Depression,self-esteem,diabetes care and self-care behaviors among middle-aged and older Mexicans

Aims

Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes.

Methods

Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression.

Results

People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors.

Conclusion

Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management.     

Observed Characteristics Associated with Diabetes Device Use Among Teens with Type 1 Diabetes

Background:Despite advancements in diabetes technologies, disparities remain with respect to diabetes device use in youth with type 1 diabetes (T1D). We compared sociodemographic, diabetes, and psychosocial characteristics associated with device (pump and continuous glucose monitor [CGM]) use in 13- to 17-year-old teens with T1D.Materials/Methods:Data were derived from a multicenter clinical trial to optimize self-care and glycemic control in teens with T1D. We categorized teens as pump users versus non-users and CGM users versus non-users based on their diabetes device usage. Chi-square and t-tests compared characteristics according to device use.Results:The sample comprised 301 teens (50% female) with baseline mean ± SD age 15.0 ± 1.3 years, T1D duration 6.5 ± 3.7 years, and HbA1c 8.5 ± 1.1% (69 ± 12 mmol/mol). Two-thirds (65%) were pump users, and 27% were CGM users. Pump users and CGM users (vs. non-users) were more likely to have a family annual household income ≥$150,000, private health insurance, and a parent with a college education (all P < .001). Pump users and CGM users (vs. non-users) also performed more frequent daily blood glucose (BG) checks (both P < .001) and reported more diabetes self-care behaviors (both P < .05). Pump users were less likely to have baseline HbA1c ≥9% (75 mmol/mol) (P = .005) and to report fewer depressive symptoms (P = .02) than pump non-users. Parents of both CGM and pump users reported a higher quality of life in their youth (P < .05).Conclusion:There were many sociodemographic, diabetes-specific, and psychosocial factors associated with device use. Modifiable factors can serve as the target for clinical interventions; youth with non-modifiable factors can receive extra support to overcome potential barriers to device use.