Adaptation of an Adult Web Application for Type 1 Diabetes Self-management to Youth Using the Behavior Change Wheel to Tailor the Needs of Health Care Transition: Qualitative Interview Study (Preprint)

Abstract

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.