Background Youth (aged 14-24 years) living with type 1 diabetes (T1D) encounter increased challenges in their diabetes self-management (DSM), especially during the transition to adult care. Although DSM education and support are imperative, there is insufficient information on how web-based digital tools tailored to their demands can be developed. Objective On the basis of the Behavior Change Wheel, this study aims to identify, among youth living with T1D, the needs and factors influencing their DSM in the context of health care transition and to inform the adaptation (content and features) of an adult self-guided web application (Support). Methods Internet-based semistructured individual interviews based on a phenomenological study design were conducted with 21 youths, and transcripts were analyzed using an inductive approach with concept mapping. Results Factors influencing T1D self-management were categorized into barriers and facilitators and then as external or internal. Features influencing the accessibility to information, increasing the sense of support, and use of the tool were positively accepted. Features unrelated to their expectations of digital tool use or difficulty navigating were viewed negatively. Participants expressed an interest in reliable, practical, and novel educational content. Although youth considered the information provided by medical professionals to be important, peer exchange was deemed necessary to obtain a practical perspective and real-life examples. Conclusions Compared with the adult population, in addition to tailored content and a simplified information search process, when building a DSM education and support digital tool for youth, features should be selected to encourage supervised peer exchange.
Introduction: Support-Pro is a comprehensive online platform that was developed for healthcare professionals (HCP) and covers all technological, treatment and lifestyle needs for type 1 diabetes (T1D) management in short, practical modules. It was developed as studies have demonstrated that HCPs who work in healthcare not specific to T1D, find it difficult to keep up-to-date with new developments that could improve T1D care and management. However, specialized online resources, such as Support-Pro, could help rectify this problem. The objective of the study is to assess whether Support-Pro can increase HCPs confidence in treating and supporting people with T1D (PWT1D) and their satisfaction with the platform. Methods: Open-label, non-randomized, 3-month trial with 142 HCPs who had access to Support-Pro, and 66 who completed 3 months on the platform (NCT04859205). Results: On average, the 66 participants (years of practice: 14±10; 90% women; 71% Caucasian; 44% dietitians, 30% nurses, 23% pharmacists, 3% physician or resident physician) reported at 3 months, an average 10% improvement in their confidence (total score 58% to 68%; p<0.0001) and a median satisfaction score of 76%. HCPs most valued features that supported knowledge gain, such as downloadable PDF documents (72%) and case studies (44%). The platform was most used in first month of access (page views 1st month: 50 [5;135] vs. 3rd month: 0 [0;18]). Conclusions: HCPs who completed 3 months on Support-Pro platform reported increased confidence in treating PWT1D and high appreciation of learning content and modalities. This platform could improve the support and advice provided to PWT1D followed-up outside specialized clinics. Disclosure A.Katz: None. R.Rabasa-lhoret: Consultant; Dexcom, Inc., Abbott, Janssen Pharmaceuticals, Inc., Novo Nordisk Canada Inc., Sanofi, Lilly, Tandem Diabetes Care, Inc., Insulet Corporation. M.K.Talbo: None. A.Housni: None. L.Hill: None. A.Roy-fleming: None. S.Haag: Other Relationship; Omnipod. A.Brazeau: Other Relationship; Dexcom, Inc., Diabète québec, Ordre des diététistes nutritionnistes du Québec, Research Support; Canadian Institutes of Health Research, Fonds de recherche du Québec en Santé. Funding Strategy Patient-Oriented Research (JT1-157204); JDRF (4-SRA-2018-651-Q-R)
Background: People with type 1 diabetes (PWT1D) perceiving high diabetes-related stigma are less likely to report in-target A1c levels. We hypothesized that people with higher levels of stigma have suboptimal psychosocial outcomes and that stigma would be perceived differently across age groups. Methods: Cross-sectional analysis of 709 PWT1D aged ≥14 years in the BETTER T1D registry (Quebec, Canada) who completed the T1D Stigma Assessment Scale (DSAS-1). The DSAS-1 (/95) includes 3 subscales; Blame & Judgment (6 items), Identity Concern (7 items), and Treated Differently (6 items). Individuals who perceived more stigma compared to the total cohort (DSAS-1 mean score +1 standard deviation), were stratified into groups by age to determine associations with diabetes self-management behaviours and outcomes. Results: Across groups, youth (n=105; 14-24 years) had the highest stigma perception (20%), followed by 18% in middle-aged adults (n=401; 35-64 years), then 15% for both young adults (n=130; 25-34 years) and seniors (n=73; 65+ years). The majority of youth, young and middle-aged adults, and seniors perceived stigma as Blame & Judgment (51%, 44%, 33%, and 19%, respectively). Stigma related to Identity Concern was highest among seniors (15%). In an age- and diabetes duration-adjusted models, 40% of adjusted variance in stigma score was explained by increased diabetes distress (p<0.001), depression (p=0.005), hyperglycemia avoidance behaviours (p<0.001), fear of hypoglycemia (p<0.001) and decreased social support (p<0.001). Conclusion: Interventions targeting diabetes-related stigma need to be tailored for different age groups to target suboptimal diabetes self-management behaviours and improve psychosocial outcomes. Disclosure A.Housni: None. A.Katz: None. J.C.Kichler: None. M.Nakhla: None. A.Brazeau: Other Relationship; Dexcom, Inc., Diabète québec, Ordre des diététistes nutritionnistes du Québec, Research Support; Canadian Institutes of Health Research, Fonds de recherche du Québec en Santé. Funding JDRF (4-SRA-2018-651-Q-R); Canadian Institutes of Health Research (JT1-157204)
BACKGROUND Youth (14 to 24 y.o.) living with type 1 diabetes (T1D) encounter increased challenges in their diabetes self-management (DSM), especially during the transition to adult care. While DSM education and support are imperative, there is insufficient information on how online platforms tailored to their demands can be developed. OBJECTIVE To identify, among youth living with T1D, needs and factors influencing their DSM in the context of healthcare transition and to inform the adaptation (content and features) of an adult self-guided web application (Support) based on the Behaviour Change Wheel. METHODS Virtual semi-structured individual interviews based on a phenomenological study design were conducted with 21 youths and transcripts were analyzed using an inductive approach with concept mapping. RESULTS Factors influencing T1D self-management were categorized into barriers and facilitators and then as external or internal. The platform features influencing the accessibility to information, increasing sense of support, and engagement with the platform were positively accepted. Features unrelated to their expectation of platform use or difficulty navigating were negatively viewed. Participants expressed interest in reliable, practical, and novel educational content. Although youth considered information provided by medical professionals to be important, peer exchange was deemed necessary to obtain a practical perspective and real-life examples. CONCLUSIONS Compared to the adult population, in addition to tailored content and a simplified information search process, when building an online DSM education and support platform for youth, features should be selected to encourage supervised peer exchange.
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