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Helgeson VS, Horner FS, Reis HT, Niezink NMD, Libman I. Support and Conflict Among Youth With Type 1 Diabetes: A Focus on Friends. J Pediatr Psychol 2023; 48:940-951. [PMID: 37740947 PMCID: PMC10653353 DOI: 10.1093/jpepsy/jsad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVE The goal of the study was to examine the relations of general and diabetes-specific friend support and conflict to psychological and diabetes health among youth with type 1 diabetes. We examined gender as a moderator of these relations, and friend responsiveness and information-sharing as potential mediators. METHODS Youth with type 1 diabetes (n = 167; M age 15.83 [SD = 0.78]; 50% female) were interviewed once in the Fall and once in the following Spring of the school year. Using multiple regression analysis, general friend support, general friend conflict, diabetes-specific support, and diabetes-specific conflict were investigated as simultaneous predictors of psychological and diabetes outcomes cross-sectionally and longitudinally over four months. RESULTS Cross-sectionally friend conflict, including both general and diabetes-specific, was more predictive of outcomes than friend support. In cross-sectional and longitudinal analyses, gender was a significant moderator, such that several relations of general friend conflict to outcomes were significant for females but not nonfemales. Friend support revealed mixed relations to outcomes across cross-sectional and longitudinal analyses. Although we found links of friend relationship variables to mediators (perceived responsiveness; information sharing), we found little evidence of mediation. CONCLUSIONS These findings show stronger evidence that conflictual friend relationships than supportive friend relationships are linked to health. Findings suggest that problematic friend relationships may have a stronger impact on the health of females than nonfemales. These results underscore the need to better understand the conditions under which friend support is helpful versus harmful and the reasons underlying these links.
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Affiliation(s)
| | - Fiona S Horner
- Department of Psychology, Carnegie Mellon University, USA
| | | | - Nynke M D Niezink
- Department of Data Science and Statistics, Carnegie Mellon University, USA
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2
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Babiker A, Elbarbary NS, Alaqeel B, Al Noaim K, Al Yaarubi S, Al-Abdulrazzaq D, Al-Kandari H, Alkhayyat H, Odeh R, Babiker O, Abu-Libdeh A, Aljohani A, Al Abdul Salam N, Al-Juailla F, Masuadi E, Deeb A, Weissberg-Benchell J, Gregory AM, Hassanein M, Al Alwan I. Lessons Learned From COVID-19 Lockdown: An ASPED/MENA Study on Lifestyle Changes and Quality of Life During Ramadan Fasting in Children and Adolescents Living With Type 1 Diabetes. Clin Med Insights Endocrinol Diabetes 2023; 16:11795514231203907. [PMID: 37867504 PMCID: PMC10588419 DOI: 10.1177/11795514231203907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/10/2023] [Indexed: 10/24/2023] Open
Abstract
Background Lockdown was a unique experience that affected many aspects of life, particularly during the challenge of Ramadan fasting (RF). Studying this can increase understanding of the effects of lifestyle changes on quality of life (QoL) for children with type 1 diabetes (T1D) during RF. Methods A cross-sectional study that assessed the effect of lockdown on lifestyle and QoL on fasting children living with T1D during Ramadan in the Middle East and North Africa region (2020-2021). We compared the child (self) and parent (proxy) reports using PEDQoL v3.0 disease specific questionnaire during lockdown and non-lockdown periods, and assessed correlations with lifestyle changes using regression and gap analyses. Results A total of 998 reports from 499 children with T1D aged 8 to 18 years (study = 276, control = 223), and their parents during RF in lockdown and non-lockdown periods. Fathers were more involved in their children's care during lockdown (P = .019). Patients had better compliance with treatment (P = .002), a reversed sleep pattern (P = .033), increased food intake (P ⩽ .001), and less exercise (P < .001). Children and parents perceived better QoL during lockdown (P ⩽.001) with no differences between their reports in "Diabetes Symptoms", "Treatment Adherence," and "Communication" domains. Self and proxy reports were different in all domains during non-lockdown (P = <.001-.009). In gap analysis, although not statistically significant, the gap was approximated between children's and parents' perceptions in all domains during lockdown. Conclusion COVID-19 lockdown had a positive impact on QoL of children living with T1D during RF, possibly due to lifestyle changes and superior psychosocial family dynamics.
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Affiliation(s)
- Amir Babiker
- King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | | | - Bothainah Alaqeel
- King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Khalid Al Noaim
- Department of Pediatrics, King Faisal University Medical Center, AlAhsa, Saudi Arabia
| | - Saif Al Yaarubi
- College of Medicine & Health Science, Sultan Qaboos University, Muscat, Oman
| | - Dalia Al-Abdulrazzaq
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Hessa Al-Kandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Farwaniya Hospital, Ministry of Health, Farwaniya, Kuwait
| | - Haya Alkhayyat
- Pediatric Department, Bahrain Defense Force Royal Medical Services, Riffa, Bahrain
| | - Rasha Odeh
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Omer Babiker
- Sudan Childhood Diabetes Center, Khartoum, Sudan
| | - Abdulsalam Abu-Libdeh
- Department of Pediatrics, Endocrinology Unit, Makassed Islamic Hospital & Al-Quds Medical School, Jerusalem, Palestine, Israel
| | - Amal Aljohani
- King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Noof Al Abdul Salam
- College of Medicine & Health Science, Sultan Qaboos University, Muscat, Oman
| | - Fatima Al-Juailla
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Emad Masuadi
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Asma Deeb
- Sheikh Shakhbout Medical City & Khalifa University, Pediatric Endocrinology, Abu Dhabi, UAE
| | - Jill Weissberg-Benchell
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Alice M. Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Mohamed Hassanein
- Department of Endocrinology and Diabetes, Dubai Hospital, Dubai, UAE
| | - Ibrahim Al Alwan
- King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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3
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Titoria R, Fung A, Tang TS, Amed S. Systematic review of technology-mediated peer support interventions in paediatric type 1 diabetes care. Diabet Med 2023; 40:e15172. [PMID: 37428650 DOI: 10.1111/dme.15172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023]
Abstract
AIMS There is increasing interest in the role of peer support in diabetes care. However, technology-mediated peer support in paediatric type 1 diabetes remains understudied.We aimed todescribe technology-mediated peer support interventions for children living with type 1 diabetes, their caregivers and healthcare providers. METHODS CINAHL, Embase and MEDLINE (Ovid) were searched from Jan 2007 to June 2022. We included randomised and non-randomised trials with peer support interventions for children living with diabetes, their caregivers and/or healthcare providers. Studies examining clinical, behavioural or psychosocial outcomes were included. Quality was assessed with the Cochrane risk of bias tool. RESULTS Twelve of 308 retrieved studies were included, with a study duration range of 3 weeks to 24 months and most were randomised trials (n = 8, 66.67%). Four technology-based interventions were identified: phone-based text messages, video, web portal and social media, or a hybrid peer support model. Most (58.6%, n = 7) studies exclusively targeted children with diabetes. No significant improvement was observed in psychosocial outcomes (quality of life, n = 4; stress and coping, n = 4; social support, n = 2). Mixed findings were observed in HbA1c (n = 7) and 28.5% studies (n = 2/7) reported reduced incidence of hypoglycaemia. CONCLUSIONS Technology-mediated peer support interventions may have the potential to improve diabetes care and outcomes. However, further well-designed studies are necessary that address the needs of diverse populations and settings, and the sustainability of intervention effects.
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Affiliation(s)
- Reena Titoria
- Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Andrea Fung
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Tricia S Tang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shazhan Amed
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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4
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Bisno DI, Reid MW, Pyatak EA, Flores Garcia J, Salcedo-Rodriguez E, Torres Sanchez A, Fox DS, Hiyari S, Fogel JL, Marshall I, Bachmann G, Raymond JK. Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes. Diabetes Technol Ther 2023; 25:589-601. [PMID: 37335751 DOI: 10.1089/dia.2023.0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Adolescents and young adults (AYA) from diverse and marginalized backgrounds with type 1 diabetes (T1D) generally have higher hemoglobin A1c (HbA1c) levels and less frequent continuous glucose monitor (CGM) use than AYA from more privileged backgrounds. Further, scant data address the impact of virtual peer groups (VPG) on health-related outcomes for ethnically and racially diverse AYA with T1D. Methods: CoYoT1 to California was a 15-month randomized controlled trial for AYA aged 16-25 years. In this study, AYA were randomized to receive standard care (n = 28), or CoYoT1 care (n = 40), which consisted of person-centered provider visits and bimonthly VPG. VPG were AYA-driven discussions. AYA completed the Diabetes Distress Scale (DDS), Center for Epidemiologic Studies Depression (CES-D), and Diabetes Empowerment Scale-Short Form (DES-SF) scales at baseline and all study visits. Results: Participants were 50% Latinx and 75% publicly insured. Among CoYoT1 care participants, 19 attended at least 1 VPG session (VPG attendees) and 21 did not attend any VPG sessions. VPG attendees participated in 4.1 VPG sessions on average. VPG attendees had a relative reduction in HbA1C (treatment effect -1.08%, effect sizes values [ES] = -0.49, P = 0.04) and increase in CGM use (treatment effect +47%, ES = 1.00, P = 0.02) compared to standard care. VPG participation was not associated with statistically significant changes in DDS, CES-D, and DES-SF scores. Conclusions: In a 15-month randomized controlled trial, AYA with T1D who participated in VPG reported significant improvements in HbA1c and CGM use. Peer interactions may support unmet needs of AYA with T1D from diverse and marginalized backgrounds. ClinicalTrials.gov Identifier: NCT03793673.
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Affiliation(s)
- Daniel I Bisno
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Mark W Reid
- Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Elizabeth A Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | | | | | | | - D Steven Fox
- School of Pharmacy, University of Southern California, Los Angeles, California, USA
| | - Sarah Hiyari
- Children's Hospital Los Angeles, Los Angeles, California, USA
| | | | - Ian Marshall
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Gloria Bachmann
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Jennifer K Raymond
- Children's Hospital Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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5
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Limbert C, Tinti D, Malik F, Kosteria I, Messer L, Jalaludin MY, Benitez-Aguirre P, Biester S, Corathers S, von Sengbusch S, Marcovecchio ML. ISPAD Clinical Practice Consensus Guidelines 2022: The delivery of ambulatory diabetes care to children and adolescents with diabetes. Pediatr Diabetes 2022; 23:1243-1269. [PMID: 36537530 DOI: 10.1111/pedi.13417] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Catarina Limbert
- Unit of Paediatric Endocrinology and Diabetes, Hospital Dona Estefânia, Lisbon, Portugal.,Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Davide Tinti
- Department of Pediatrics, University of Turin, Turin, Italy
| | - Faisal Malik
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Ioanna Kosteria
- Department of Endocrinology, Growth & Development, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Laurel Messer
- Barbara Davis Center, University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Paul Benitez-Aguirre
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Biester
- Diabetes-Center for Children and Adolescents, Children's Hospital "Auf der Bult", Hannover, Germany
| | - Sarah Corathers
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Simone von Sengbusch
- Division of Pediatric Endocrinology and Diabetology, Campus Lübeck, University Medical Centre Schleswig-Holstein, Lübeck, Germany
| | - M Loredana Marcovecchio
- Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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6
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Gregory JW, Cameron FJ, Joshi K, Eiswirth M, Garrett C, Garvey K, Agarwal S, Codner E. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes in adolescence. Pediatr Diabetes 2022; 23:857-871. [PMID: 36250644 PMCID: PMC9828225 DOI: 10.1111/pedi.13408] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/12/2023] Open
Affiliation(s)
- John W. Gregory
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Fergus J. Cameron
- Royal Children's HospitalMelbourneAustralia,Murdoch Children's Research InstituteMelbourneAustralia,Department of PaediatricsUniversity of MelbourneMelbourneAustralia
| | - Kriti Joshi
- Department of Endocrinology & DiabetesQueensland Children's HospitalSouth BrisbaneAustralia
| | - Mirjam Eiswirth
- Department of Anglophone StudiesUniversität Duisburg EssenEssenGermany
| | - Christopher Garrett
- Institute of Psychiatry, Psychology and NeuroscienceBart's Health and East London Foundation TrustLondonUK
| | - Katharine Garvey
- Division of EndocrinologyBoston Children's HospitalBostonMassachusettsUSA
| | - Shivani Agarwal
- Department of Medicine (Endocrinology), Albert Einstein College of MedicineMontefiore Medical CenterBronxNew YorkUSA
| | - Ethel Codner
- Instituto de Investigaciones Materno Infantil, Facultad de MedicinaUniversity of ChileSantiagoChile
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7
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Liu Z, Wang C, Yang D, Luo S, Ding Y, Xu W, Zheng X, Weng J, Yan J. High engagement in mobile peer support is associated with better glycemic control in type 1 diabetes: a real-world study. J Diabetes Investig 2022; 13:1914-1924. [PMID: 35708894 DOI: 10.1111/jdi.13870] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 05/05/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022] Open
Abstract
AIMS Peer support for diabetes has become convenient and interactive following the emergence of mobile health (mHealth). We aimed to evaluate the association between engagement in peer support via mHealth app and glycemic control in type 1 diabetes (T1D). METHODS This retrospective study included adults with T1D who had joined the mobile community "TangTangQuan (TTQ)" since May 2018 for at least one year. "Like", "comment" and "share" were the major interaction indicators of mobile community and were used to assess engagement in peer support. The patients were divided into four engagement groups by quartile. The primary outcome was the change in HbA1c , mean fasting blood glucose (FBG) and postprandial blood glucose (PBG) from baseline to the 12th month. Other outcomes included the change of self-monitoring of blood glucose frequency, hypoglycemia frequency, and the proportion of reaching optimal glycemic control. RESULTS Among the 693 individuals, the HbA1c , mean FBG and PBG improved in the 12th month. Multiple regression analysis showed that higher engagement in peer support was associated with a greater reduction of HbA1c (β=-0.45, P<0.001) and mean FBG (β=-0.82, P<0.001). In the subgroup of poor glycemic control, the association between engagement in peer support and glycemic improvement still remained (HbA1c : β=-0.86, P=0.002; FBG: β=-1.36, P=0.001). The engagement in mobile peer support was positively correlated with educational level (OR=1.42, P=0.042), household income (OR=1.43, P=0.013), and the use of continuous subcutaneous insulin infusion (OR=1.73, P=0.009). CONCLUSION High engagement in mobile peer support was associated with better glycemic control in adults with T1D.
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Affiliation(s)
- Ziyu Liu
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Chaofan Wang
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Yu Ding
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jianping Weng
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China.,Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
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8
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Titoria R, Amed S, Tang TS. Peer Support Interventions on Digital Platforms for Children With Type 1 Diabetes and Their Caregivers. Diabetes Spectr 2022; 35:26-32. [PMID: 35308148 PMCID: PMC8914597 DOI: 10.2337/ds21-0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Peer support for children with type 1 diabetes and their caregivers has been recognized as a key component in diabetes management and mental health. In this era of digitization, support programs delivered via technology are growing rapidly, particularly with increased access to technology and social media. Although the development of different digital modalities for this purpose is in its early stages, five different types of digital platforms have been recognized: voice, text, website, video, and social media. This article discusses the significance of peer support and explores various digital peer support interventions in pediatric patients with type 1 diabetes (0-18 years of age) and their caregivers.
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Affiliation(s)
- Reena Titoria
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Corresponding author: Reena Titoria,
| | - Shazhan Amed
- BC Children’s Hospital Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tricia S. Tang
- Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada
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9
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Carreon SA, Duran B, Tang TS, Streisand R, Anderson BJ, Lyons SK, McKay S, Hilliard ME. Here for You: A Review of Social Support Research in Young Adults With Diabetes. Diabetes Spectr 2021; 34:363-370. [PMID: 34866869 PMCID: PMC8603130 DOI: 10.2337/dsi21-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Living with and managing diabetes is challenging during young adulthood, and social support may help relieve or minimize the burdens young adults with diabetes experience. This article reviews the types and sources of support young adults with diabetes receive and their associations with behavioral, psychosocial, and glycemic outcomes. Intervention research integrating social support and future directions for care are discussed.
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Affiliation(s)
| | - Brenda Duran
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
| | - Tricia S. Tang
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Randi Streisand
- Children’s National Hospital, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | | | - Sarah K. Lyons
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
| | - Siripoom McKay
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
| | - Marisa E. Hilliard
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
- Corresponding author: Marisa E. Hilliard,
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10
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Agarwal S, Crespo-Ramos G, Long JA, Miller VA. "I Didn't Really Have a Choice": Qualitative Analysis of Racial-Ethnic Disparities in Diabetes Technology Use Among Young Adults with Type 1 Diabetes. Diabetes Technol Ther 2021; 23:616-622. [PMID: 33761284 PMCID: PMC8501459 DOI: 10.1089/dia.2021.0075] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Racial-ethnic disparities in diabetes technology use are well documented in young adults (YA) with type 1 diabetes (T1D), but modifiable targets for intervention still need to be identified. Our objective was to explore YA perspectives on technology access and support in routine clinical care. Materials and Methods: Participants were YA with T1D of Hispanic or non-Hispanic Black race-ethnicity from pediatric and adult endocrinology clinics in the Bronx, NY. We conducted semistructured individual interviews to explore how health care and personal experiences affected technology use. Interviews were audio-recorded and transcribed for analysis. We used a modified inductive coding approach with two independent coders and iterative coding processes to improve data reliability and validity. Results: We interviewed 40 YA with T1D: mean age 22 years; 62% female; 72% Medicaid insured; 72% Hispanic; 28% non-Hispanic Black; and mean hemoglobin A1C 10.3%. Themes were categorized into potentially exacerbating and alleviating factors of racial-ethnic disparities in technology use. Exacerbating factors included perceptions that providers were gatekeepers of information and prescription access to technology, providers did not employ shared decision making for use, and YA biases against technology were left unaddressed. Alleviating factors included provider optimism and tailoring of technology benefits to YA needs, and adequate Medicaid insurance coverage. Conclusions: Our results reveal potential intervention targets at the provider level to increase technology uptake among underrepresented YA with T1D. Diabetes health care providers need to be aware of inadvertent withholding of information and prescription access to technology. Provider approaches that address YA technology concerns and promote shared decision making help to mitigate racial/ethnic disparities in technology use.
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Affiliation(s)
- Shivani Agarwal
- Fleischer Institute for Diabetes and Metabolism, Montefiore Medical Center, Bronx, New York, USA
- NY-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, New York, USA
- Address correspondence to: Shivani Agarwal, MD, MPH, Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, 1180 Morris Park Avenue, Bronx, NY 10461, USA
| | - Gladys Crespo-Ramos
- Fleischer Institute for Diabetes and Metabolism, Montefiore Medical Center, Bronx, New York, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Judith A. Long
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Victoria A. Miller
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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11
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"They Think It's Helpful, but It's Not": a Qualitative Analysis of the Experience of Social Support Provided by Peers in Adolescents with Type 1 Diabetes. Int J Behav Med 2020; 27:444-454. [PMID: 32291619 DOI: 10.1007/s12529-020-09878-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Adherence in type 1 diabetes has previously been found to be improved with effective social support. However, research has so far been unable to elucidate the effect of social support from peers in adolescents with type 1 diabetes, with studies concluding they may be both positively and negatively related to self-care and glycaemic control. The present study explores the experience of social support from peers in adolescents with type 1 diabetes using a qualitative methodology to address this lack of consensus in the literature, using the research question: "what is the meaning and experience of social support from peers in adolescents with type 1 diabetes?" METHODS Semi-structured interviews using the Diabetes Social Support Interview schedule were employed. Twelve participants aged 15-18 were recruited from paediatric outpatient services. Transcripts were analysed using thematic analysis. RESULTS Two overarching themes were noted within transcripts; A Sense of Normality and "They Think It's Helpful, But It's Not". Overall, participants reported a desire for global support from peers and explored how and why diabetes-specific support behaviours were more likely to be interpreted as harassing. CONCLUSIONS These findings suggest that diabetes-specific support may not always be advantageous in aiding adolescents to reach and maintain optimal self-care. In addition, participants emphasise the acceptability of advice provided by peers with type 1 diabetes, making peer support and mentoring programmes an excellent candidate for future research.
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Sullivan-Bolyai S, Bova C, Johnson K. Development and Psychometric Testing of the Peer-Mentor Support Scale for Parents of Children With Type 1 Diabetes and for Youths With Type 1 Diabetes. DIABETES EDUCATOR 2020; 46:191-196. [PMID: 32133921 DOI: 10.1177/0145721720907055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to develop and evaluate the psychometric properties of the Peer-Mentor Support Scale (PMSS), a measure of peer-mentor support provided to parents of children with type 1 diabetes (T1D) and to youths with T1D. METHODS A multistage process was undertaken to include the following: item construction based on qualitive data from those who have experienced peer-mentor support, cognitive interviewing with parents and youths, content validity assessment, pilot testing of the scale, and psychometric evaluation of the PMSS with 165 participants. RESULTS The final version of the PMSS included 17 items, scored on a 4-point Likert scale, with higher scores corresponding with greater peer-mentor support. The Cronbach's alpha was .85 (n = 165), and the intraclass correlation coefficient was .78 (n = 38). No significant relationship was found between the PMSS score and general social support, suggesting that peer-mentor support is distinct from general social support. Principal components factor analysis with varimax rotation was performed, indicating that the scale was unidimensional and explained 59.3% of the variance in peer-mentor support. CONCLUSION The PMSS is a reliable and valid 17-item instrument that can be used to measure the unique contributions of peer mentorship for parents of children with T1DM and for youths with T1DM.
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Affiliation(s)
- Susan Sullivan-Bolyai
- University of Massachusetts Medical School Graduate School of Nursing, Worcester, Massachusetts
| | - Carol Bova
- University of Massachusetts Medical School Graduate School of Nursing, Worcester, Massachusetts
| | - Kimberly Johnson
- UMASS Memorial Health Care, Member of Pediatric Diabetes Care Team, Worcester, Massachusetts
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Ash GI, Joiner KL, Savoye M, Baker JS, Gerosa J, Kleck E, Patel NS, Sadler LS, Stults-Kolehmainen M, Weinzimer SA, Grey M. Feasibility and safety of a group physical activity program for youth with type 1 diabetes. Pediatr Diabetes 2019; 20:450-459. [PMID: 30834621 PMCID: PMC6508986 DOI: 10.1111/pedi.12841] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/OBJECTIVE Many adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate-to-vigorous intensity physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population. METHODS Eighteen adolescents with type 1 diabetes (age 14.1 ± 2 .3 years, female 67%, black or Latino 67%, median body mass index 92%'ile, A1c 79.9 ± 25.1 mmol/mol, 9.5 ± 2.3%). Intervention sessions (35 minutes MVPA and 45 minutes discussion) occurred 1×/week for 12 weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3 months, and 7 months. Hedges' effect sizes were calculated. RESULTS Enrollment was 16%, and intervention completion was 56%. Assessment completion at 7 months was 67% for MVPA, nutrition, and fitness, 83% for psychosocial assessments, and 94% for clinical assessments. Cost was $1241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6%). Self-reported daily fruit/vegetable servings (d = -0.72) and diabetes self-management behaviors decreased over time (d = -0.40). In the 10 completers, endurance run score improved (d = 0.49) from low baseline levels, while systolic blood pressure decreased (d = -0.75) and low-density lipoprotein increased (d = 0.49) but stayed within normal ranges. CONCLUSIONS The protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained suboptimal, suggesting the need for more intensive interventions for this population.
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Affiliation(s)
- Garrett I. Ash
- Yale University School of Nursing, West Haven, CT, USA, 06516
| | - Kevin L. Joiner
- Yale University School of Nursing, West Haven, CT, USA, 06516
| | - Mary Savoye
- Yale University, Department of Pediatric Endocrinology, New Haven, CT, USA, 06520
| | - Julien S. Baker
- University of the West of Scotland, Institute of Clinical Exercise and Health Sciences, Paisley, Scotland, UK, PA1 2BE
| | - James Gerosa
- Southern Connecticut State University Exercise Science Department, New Haven, CT, USA, 06515
| | - Emma Kleck
- Yale University School of Nursing, West Haven, CT, USA, 06516
| | - Neha S. Patel
- Penn State Milton S. Hershey Medical Center Division of Endocrinology, Hershey, PA, USA, 17033
| | - Lois S. Sadler
- Yale University School of Nursing, West Haven, CT, USA, 06516
| | | | - Stuart A. Weinzimer
- Yale University, Department of Pediatric Endocrinology, New Haven, CT, USA, 06520
| | - Margaret Grey
- Yale University School of Nursing, West Haven, CT, USA, 06516
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Dizon S, Malcolm J, Rowan M, Keely EJ. Patient Perspectives on Managing Type 1 Diabetes During High-Performance Exercise: What Resources Do They Want? Diabetes Spectr 2019; 32:36-45. [PMID: 30853763 PMCID: PMC6380235 DOI: 10.2337/ds18-0016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Athletes with type 1 diabetes face unique challenges that make it difficult for health care providers to offer concise recommendations for diabetes management. Moreover, little is known about patient preferences for diabetes management during high-level and competitive exercise. We undertook a qualitative study to understand patient perspectives on managing type 1 diabetes during exercise. METHODS A qualitative design using focus groups was selected. Samples of 5-10 participants per group were recruited to participate in one of three 1.5-hour sessions focusing on experiences in managing diabetes, supports, and desired resources. Sessions were audiotaped and transcribed verbatim. Data were analyzed iteratively among team members. RESULTS The study included 21 participants (10 male and 11 female) with a mean age of 41 years. Most participants used trial and error to manage their blood glucose around exercise. Frequent monitoring of blood glucose was a common strategy and a challenge during exercise. Hypoglycemia after exercise and adrenaline-fueled hyperglycemia during exercise were the most prevalent concerns. Most participants relied on themselves, an endocrinologist, or the Internet for support but said they would prefer to rely more on peers with type 1 diabetes and mobile apps. Peer support or mentorship was strongly supported with recommendations for moving forward. CONCLUSION This study highlights the individualized nature of balancing glycemic control in athletes and athletes' heavy self-reliance to develop strategies. Expanding the availability of resources such as peer mentoring and mobile apps could potentially support athletes with type 1 diabetes.
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Affiliation(s)
- Stephanie Dizon
- University of Ottawa, Department of Medicine, Division of Endocrinology & Metabolism, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Janine Malcolm
- University of Ottawa, Department of Medicine, Division of Endocrinology & Metabolism, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Margo Rowan
- Rowan Research & Evaluation, Ottawa, Ontario, Canada
| | - Erin J. Keely
- University of Ottawa, Department of Medicine, Division of Endocrinology & Metabolism, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
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Pihoker C, Forsander G, Fantahun B, Virmani A, Corathers S, Benitez-Aguirre P, Fu J, Maahs DM. ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes. Pediatr Diabetes 2018; 19 Suppl 27:84-104. [PMID: 30144259 DOI: 10.1111/pedi.12757] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/10/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Catherine Pihoker
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Gun Forsander
- Division of Diabetes, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bereket Fantahun
- Department of Pediatrics and Child Health at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Anju Virmani
- Department of Pediatrics, Max, Pentamed and SL Jain Hospitals, Delhi, India
| | - Sarah Corathers
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Paul Benitez-Aguirre
- Sydney Medical School, Discipline of Child & Adolescent Health, The Children's Hospital at Westmead Clinical School Children's Hospital, Westmead, New South Wales, Australia
| | - Junfen Fu
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - David M Maahs
- Department of Pediatrics, Stanford University, Stanford, California
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Ye CY, Jeppson TC, Kleinmaus EM, Kliems HM, Schopp JM, Cox ED. Outcomes That Matter to Teens With Type 1 Diabetes. DIABETES EDUCATOR 2017; 43:251-259. [PMID: 28520550 DOI: 10.1177/0145721717699891] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose The purpose of the study was to describe outcomes that matter to teens with type 1 diabetes. Understanding outcomes that matter to teens could support successful interventions to improve diabetes self-management. Methods Fifty publicly available posts published in the "teen" sections of 2 major diabetes online forums between 2011 and 2013 were analyzed using qualitative research methods. From each post, content and descriptive data (eg, duration of diabetes and age) were collected. Two members of the research team independently used open coding techniques to identify outcomes (defined as impacts or consequences of type 1 diabetes) and organized them into themes and subthemes. A codebook was jointly developed to facilitate the identification of meaningful outcomes from the posts. Results Teens' average age was 15.7 years, and the average time since diabetes diagnosis was 6.3 years. The 3 most commonly mentioned outcomes were (1) interactions with peers ("I want to talk to someone who understands"), (2) emotional well-being ("Diabetes makes me want to cry"), and (3) blood glucose management ("My blood sugar never goes down"). Other identified outcomes included (4) physical well-being, (5) education and motivation of others, (6) family interactions, (7) academic achievement, and (8) interactions with important others such as teachers. Conclusions While teens are concerned about control of their blood glucose, there are many other outcomes that matter to them. Health care providers and diabetes educators may want to consider these other outcomes when motivating teens with type 1 diabetes to improve blood glucose control.
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Affiliation(s)
- Clara Y Ye
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Thor C Jeppson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Ellen M Kleinmaus
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Harald M Kliems
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Jennifer M Schopp
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Elizabeth D Cox
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
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Sullivan-Bolyai S, Crawford S, Johnson K, Ramchandani N, Quinn D, D'Alesandro B, Stern K, Lipman T, Melkus G, Streisand R. PREP-T1 (Preteen Re-Education With Parents-Type 1 Diabetes) Feasibility Intervention Results. JOURNAL OF FAMILY NURSING 2016; 22:579-605. [PMID: 27903941 DOI: 10.1177/1074840716676589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
There has been a 2% to 3% increase in Type 1 diabetes (T1D) in children below 11 years old. Preteens (9-12 years old) with T1D are often overlooked regarding future diabetes self-management (DSM) expectations because parents are still in the "driver's seat." The study purpose was to explore feasibility/ability to recruit and conduct a two-arm trial on reeducation, collaboration, and social support. One component of DSM was reviewed (hypoglycemia) with preteens (n = 22) and parents (n = 22). The experimental preteens discussed hypoglycemia management with a teen mentor and nurse educator using a human patient simulator for practice, and working collaboratively with parents. Concurrently, mothers met with a parent mentor and psychologist to discuss growth and development, and collaborative shared management. Comparison dyads discussed hypoglycemia management with a nurse. Preteens slightly improved in diabetes knowledge; the experimental arm had higher problem-solving scores. Parents in the experimental arm had higher self-efficacy scores. Findings will inform future research.
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Ramchandani N, Maguire LL, Stern K, Quintos JB, Lee M, Sullivan-Bolyai S. PETS-D (parents education through simulation-diabetes): Parents' qualitative results. PATIENT EDUCATION AND COUNSELING 2016; 99:1362-7. [PMID: 27021779 PMCID: PMC4931973 DOI: 10.1016/j.pec.2016.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 03/12/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Parents who have a child newly diagnosed with type 1 diabetes (T1D) must quickly learn daily diabetes self-management. An RCT was conducted using human patient simulation (HPS) to enhance parents learning diabetes self-management with children with new-onset T1D. The purpose of this study was to describe parents' perspectives of using HPS to augment diabetes education. METHODS A qualitative descriptive design was used with open-ended in-depth interviews of parents (n=49) post-intervention. Qualitative directed content analysis was used. RESULTS The majority of parents were positive about learning with HPS. Although a few parents said the HPS was "hokey" or "creepy," most reported the visual and hands-on learning was realistic and very beneficial. Seeing a seizure increased their fear although they would have panicked if they had not had that learning experience, and it helped build their diabetes self-management confidence. Recommendations included teaching others with the HPS (grandparents, siblings, babysitters, and school nurses). CONCLUSION HPS-enhanced education is an acceptable and viable option that was generally well-received by parents of children with new-onset T1D. PRACTICE IMPLICATIONS The technique should be studied with parents of children with other chronic illnesses to see if the benefits found in this study are applicable to other settings.
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Affiliation(s)
| | | | - Kailyn Stern
- New York University College of Nursing, NY, NY, USA
| | | | - Mary Lee
- University of Massachusetts Worcester, Worcester, MA, USA
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Colas C. Le patient expert, le patient ressource, le patient aidant ou tutoriel… Qui est-il ? Un nouveau professionnel de santé ? Quel rôle peut-il jouer ? Exercera-t-il un contre-pouvoir s’il possède « le » savoir ? ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1957-2557(15)30220-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
PURPOSE OF REVIEW Adolescence is a well known, high-risk time period for all youth, and in patients with type 1 diabetes, glycemic control is at its worst. This manuscript will review updates in adolescent diabetes literature between February 2014 and February 2015. The article will highlight new research in the behavioural and psychosocial literature focused on type 1 diabetes in adolescents, including compliance with standards of care, quality of life, depression, psychological burden of type 1 diabetes, parental involvement, the parent-child relationship, self-management, socioeconomic status and transition and transfer of care. Recent behavioural interventions focusing on adolescents with type 1 diabetes will also be discussed. RECENT FINDINGS These literature updates have found that behavioural and psychosocial concerns remain prevalent in adolescents with type 1 diabetes, psychological needs in the population are not being met and current interventions have not been largely successful in impacting outcomes. SUMMARY Behavioural and psychosocial issues in adolescents with type 1 diabetes greatly impact their diabetes and general life outcomes. Additional research, specifically interventions successfully addressing the behavioural and psychosocial issues in this population, is desperately needed.
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Affiliation(s)
- Jennifer Raymond
- The Barbara Davis Center for Childhood Diabetes, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Colorado, USA
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Hughes P, Johnson K, Ramchandani N, Quinn D, D’Alesandro B, Streisand R, Sullivan-Bolyai S. Preteen-Parent Experiences With PREP-T1 Feasibility Intervention. DIABETES EDUCATOR 2015; 41:452-8. [DOI: 10.1177/0145721715587743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose The purpose of this article is to report the focus group perspectives of preteens’ and parents’ experiences with a feasibility intervention entitled PREP-T1 (Preteen Re-Education with Parents–Type 1 Diabetes), an interactive education and peer mentoring intervention. Methods The parent and preteen focus groups were conducted by the principal investigator, coinvestigator, and note takers at 2 sites. The preteen-parent groups were conducted concurrently with a total of 11 preteens and 11 parents. Note-based qualitative content analysis was used, resulting in preteen-parent perspectives on reeducation and strategies for families to work more effectively in managing type 1 diabetes (T1DM). Results The findings suggest that the preteens enjoyed learning about their diabetes management from a teen educator mentor in conjunction with a human patient simulator. They reported this type of peer support would benefit other preteens with T1DM. Parents were overwhelmingly positive about their interactions with the parent educator mentor in conjunction with the psychologist and about focusing on how to better collaborate with their preteens on diabetes management decision making. Further recommendations about the timing and intervention dose were also discussed. Conclusions Moderated peer mentoring with technology has potential as a means for teaching preteens and their parents shared diabetes management. These data will be used to inform the PREP-T1 fully powered intervention study.
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Affiliation(s)
- Patricia Hughes
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
| | - Kim Johnson
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
| | - Neesha Ramchandani
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
| | - Diane Quinn
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
| | - Bianca D’Alesandro
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
| | - Randi Streisand
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
| | - Susan Sullivan-Bolyai
- New York University College of Nursing, New York, NY, USA (Ms Hughes, Ms Ramchandani, Ms D’Alesandro, Dr Sullivan-Bolyai)
- University of Massachusetts, Worcester, Worcester, MA, USA (Ms Johnson, Ms Quinn)
- Children’s National Medical Center, Washington, DC, USA (Dr Streisand)
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