• Anjali Gopalan, Maruta A Blatchins, Karen K Xu, Andrea Altschuler, Cassondra J Marshall, Danielle M Hessler, Alicia Fernandez, and Richard W Grant.
• From the Kaiser Permanente Northern California, Division of Research, Oakland, CA (AG, MAB, KKX, AA, and RWG); University of California, Berkeley, Division of Community Health Science, Berkeley, CA (CJM); University of California San Francisco (DMH and AF). Anjali.Gopalan@kp.org.
• J Am Board Fam Med. 2022 Mar 1; 35 (2): 341-351.

ObjectiveAdults with type 2 diabetes diagnosed at a younger age are at increased risk for poor outcomes. We examined life stage-related facilitators and barriers to early self-management among younger adults with newly diagnosed type 2 diabetes.Research Design And MethodsWe conducted 6 focus groups that each met twice between November 2017 and May 2018. Participants (n = 41) were aged 21 to 44 years and diagnosed with type 2 diabetes during the prior 2 years. Transcripts were coded using thematic analysis and themes were mapped to the Capability-Opportunity-Motivation-Behavior framework.ResultsParticipants were 38.4 (±5.8) years old; 10 self-identified as Latinx, 12 as Black, 12 as White, and 7 as multiple or other races. We identified 9 themes that fell into 2 categories: (1) the impact of having an adult family member with diabetes, and (2) the role of nonadult children. Family members with diabetes served as both positive and negative role models, and, for some, personal familiarity with the disease made adjusting to the diagnosis easier. Children facilitated their parents' self-management by supporting self-management activities and motivating their parents to remain healthy. However, the stress and time demands resulting from parental responsibilities and the tendency to prioritize children's needs were perceived as barriers to self-management.ConclusionsOur results highlight how the life position of younger-onset individuals with type 2 diabetes influences their early experiences. Proactively addressing perceived barriers to and facilitators of self-management in the context of family history and parenthood may aid in efforts to support these high-risk, younger patients.© Copyright 2022 by the American Board of Family Medicine.

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