{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T08:58:54Z","timestamp":1790499534848,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","award":["5K23DK131342"],"award-info":[{"award-number":["5K23DK131342"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"abstract":"<jats:p>\n                    Continuous glucose monitoring (CGM) and insulin pumps improve glycemic outcomes and quality of life for youth with type 1 diabetes, yet utilization remains suboptimal. We analyzed cross-sectional data from 84 parent-youth dyads in the Building the Evidence to Address Disparities in Type 1 Diabetes study. Youth using both CGM and pump were classified as technology utilizers. Adjusted prevalence ratios (aPR) evaluated associations of sociodemographic variables with utilization. Parents of utilizers were older (standardized mean difference [SMD] = 0.74), had higher education (SMD = 0.91), and youth had longer diabetes duration (SMD = 0.49). Underutilizers endorsed higher youth discrimination (4.23 vs 2.49,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.016) and greater CGM-burden (2.34 vs 1.84,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001), while technology acceptance was higher among utilizers (4.40 vs 3.91,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.007). Parental age (aPR = 1.03, 95% CI: [1.01,1.05],\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.003), parental education (aPR = 1.10, 95% CI: [1.01,1.19],\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.03), and Non-White + non-English caregivers (aPR = 1.58, 95% CI: [1.01,2.48],\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.046) were associated with higher utilization. Youth discrimination (aPR = 0.94, 95% CI: [0.89,1.00],\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.04) was associated with lower utilization. Technology utilization was associated with structural characteristics and youth-reported experiences, with youth discrimination identifying experiential factors that may influence adoption of diabetes technologies.\n                  <\/jats:p>","DOI":"10.1177\/15209156261489913","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:29:09Z","timestamp":1790324949000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Utilization and Underutilization of Diabetes Technology in Underrepresented Families Living with Type 1 Diabetes"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-4309","authenticated-orcid":false,"given":"Ananta","family":"Addala","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."},{"name":"Stanford Diabetes Research Center, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Garfias Silva","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Figg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9930-0350","authenticated-orcid":false,"given":"Sarah J.","family":"Hanes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Medina Pe\u00f1aranda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J.","family":"Chamberlain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Naranjo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer K.","family":"Raymond","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Maahs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."},{"name":"Stanford Diabetes Research Center, Stanford University, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korey K.","family":"Hood","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA."},{"name":"Stanford Diabetes Research Center, Stanford University, Stanford, California, 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