2054-P: Closing the Gap: A Qualitative Study of Provider Perspectives on Barriers to Glycemic Control in the Latinx Population

Introduction and Objective: Among Latinx patients, diabetes prevalence is high with disproportionately elevated rates of poor glycemic control and diabetes-related complications nationally. Locally, we observe similar disparity gaps in our urban academic medical center, with Latinx patients having worse glycemic control than other groups. This qualitative study aimed to understand provider perspectives on barriers to glycemic control and opportunities to improve diabetes care for this high-risk population. Methods: We conducted nine semi-structured interviews with diabetes care providers across various ambulatory clinics. Interview transcripts were analyzed and coded using qualitative methods to identify common themes and system-level opportunities to improve diabetes care delivery within our health care system. Results: Participants included four endocrinologists, three primary care providers, and two diabetes educators who care for a high volume of Latinx patients with diabetes. Providers described multiple contributors to poor glycemic control, including structural and system-level barriers. Key themes included gaps in culturally tailored education, delays in diabetes education referrals, lack of standardized diabetes resources, and challenges with care coordination. Conclusion: Across interviews, we identified four system-level opportunities to improve diabetes care: (1) culturally tailored education, (2) enhanced integration and promotion of systemwide resources, (3) optimization of the diabetes education referral process, and (4) development of a multidisciplinary support team for high-needs patients. These findings highlight actionable system-level changes that are potentially applicable locally as well as beyond our own institution. We also plan to integrate our findings with patient-voice interviews to ensure future interventions are aligned with patients' needs and reduce disparities in glycemic outcomes. Disclosure D. Torres: None. S. Du: None. L. Nunez: None. S. Lambrechts: None. M. Freeby: Research Support; Ended; Fractyl Health, Inc., Novo Nordisk.