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

Abstract

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.

Facilitating the Virtual Exercise Games for Youth with T1D (ExerT1D) Peer Intervention: Protocol Development and Feasibility

“…32 In real-world contexts, 91% of adolescents with T1D report that their parents discourage MVPA. 7 Support from peers and peer mentors, however, was rated as important by adolescents with T1D 41,42 and associated with increased diabetes self-care. 43 Peer support for adolescents with T1D should be applied to MVPA and other general health metrics, whereas to date it has only been applied to T1D-specific behaviors.…”

14. Children and Adolescents: Standards of Care in Diabetes—2024

“…Research on effective interventions to promote successful transition to adult care is limited, although there are promising developments that may improve attendance at follow-up appointments and lower hospitalizations (293). Use of transition coordinators, technology to support communication with young adults, and other interventions may be useful in addressing the identified needs and preferences of young adults for transition (294) and in supporting successful establishment in adult care settings (295)(296)(297)(298)(299)(300). Given the behavioral, psychosocial, and developmental factors that relate to this transition, diabetes care teams addressing transition should include physicians, certified diabetes care and education specialists, nurses, behavioral health professionals, nutritionists, and social workers (61,301).…”