2121-P: “Burnout: It's the Moral Injury That Occurs”: Findings from the BEAD-T1D Study

Introduction and Objective: Clinicians play a crucial role in identifying and navigating disparities in T1D outcomes, compounded by inequities in healthcare access, resources, and systems of care. The BEAD-T1D study explores clinicians’ experiences delivering T1D care to better understand barriers to equitable management and identify opportunities to improve care for youth with T1D. Methods: Semi-structured interviews (n=12) were conducted with US pediatric clinicians (endocrinologists, diabetes educators, and nurse practitioners). Transcripts were analyzed inductively. A codebook was developed by a four-person coding team. Each transcript was independently double-coded, with discrepancies resolved by a third coder. Final themes were consolidated, and representative quotes were selected to identify key barriers and opportunities for improving equitable T1D care. Results: Clinician burnout significantly influenced T1D care delivery (Figure). Burnout was driven by the four interconnected levels of the Social Ecological Model spanning structural barriers in diabetes, social determinants of health, language and culture, and clinician burden. Conclusion: The cumulative burden experienced by clinicians contributes to disparities in the quality and consistency of T1D care for youth. Addressing these multilevel barriers, including expanding access to user-friendly diabetes technologies, is essential to promoting equitable and sustainable diabetes management. Disclosure A.M. Medina: None. J. Dixon: None. N.L. Arthur: None. D. Garfias Silva: None. L. Figg: None. S. Hanes: None. G.M. Shaw: None. D. Naranjo: None. J. Raymond: None. D. Maahs: Advisory Panel; Current; Abbott Diabetes, Sanofi, Medtronic, biospex, enable biosciences, kriya. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. A. Addala: None.