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Aims: Children and young people with diabetes (CYPD) from socio‐economically deprived and/or ethnic minority groups tend to have poorer glucose control and greater risk of diabetes‐related complications. In this systematic review of qualitative evidence (qualitative evidence synthesis, QES), we aimed to explore the experiences and views of clinical encounters in diabetes care from the perspectives of CYPD and their family/carers from underserved communities and healthcare professionals in diabetes care. Methods: We searched 6 databases to March 2022 with extensive search terms, and used a thematic synthesis following methods of Thomas and Harden. Results: We identified 7 studies and described 11 descriptive themes based on primary and secondary constructs. From these, three "analytical themes" were developed. (1) "Alienation of CYPD" relates to their social identity and interaction with peers, family and health service practitioners in the context of diabetes self‐ and family/carer management and is impacted by communication in the clinical encounter. (2) "Empowerment of CYPD and family/carers" explores families' understanding of risks and consequences of diabetes and taking responsibility for self‐ and family/carer management in the context of their socio‐cultural background. (3) "Integration of diabetes (into self and family)" focuses on the ability to integrate diabetes self‐management into the daily lives of CYPD and family/carers beyond the clinical consultation. Conclusions: The analytical themes are interdependent and provide a conceptual framework from which to explore and strengthen the therapeutic alliance in clinical encounters and to foster greater concordance with treatment plans. Communicating the biomedical aspects of managing diabetes in the clinical encounter is important, but should be balanced with addressing socio‐emotional factors important to CYPD and family/carers. [ABSTRACT FROM AUTHOR]

Objective: This study seeks to understand family's perceptions of their care at a paediatric weight management service, with a view to informing service improvement.Design: A qualitative service review conducted via semistructured interviews with parents (n=11) and children (n=3) who attended the clinic. The recruitment was open to all, but those who were not succeeding in their weight-loss goals self-selected to participate. Self-Determination Theory was used as a framework to explore families' experiences of the clinic.Setting: Recruitment occurred during clinical appointments and interviews were conducted over the phone in the days following the appointments.Patients: The service sees paediatric patients with a body mass index >99th percentile, with comorbidities or safeguarding concerns.Interventions: The clinic's service includes appointments typically every 2 months, with a multidisciplinary team including consultant endocrinologists, a dietician, a clinical psychologist, a social worker and a clinical nurse specialist.Main Outcome Measures: Families' feedback on the multi-disciplinary team (MDT) clinic, and their perceptions of how improvements could be made.Results: Families perceive a lack of autonomy, competency and feel a lack of connectivity both in their lives broadly and within their experience at the clinic.Conclusions: Interventions in families struggling with weight improvements should see the clinical team placing more emphasis on working alongside parents to develop young people's sense of self-determination. Expectations must be set that success originates from changes outside of clinical appointments and that the clinical team is in place to support the family's development of sustainable, self-determined lifestyle habits. [ABSTRACT FROM AUTHOR]