An Integrative Review of the Quality and Outcomes of Diabetes Education Programs for Children and Adolescents

Colson, Sébastien; Côté, José; Gentile, Stéphanie; Hamel, Valérie; Sapuppo, Cédric; Ramirez-Garcia, Pilar; Reynaud, Rachel; Lagouanelle-Simeoni, Marie-Claude

doi:10.1177/0145721716658976

Cited by 20 publications

(20 citation statements)

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“…The quality of the educational interventions was assessed using the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommendations, according to the 19 key criteria selected by Colson et al These recommendations evaluate the impact of educational interventions on both diabetes knowledge and psychosocial outcomes such as self‐management, and belong to the ISPAD Guidelines from 2009 and 2014, subsequently updated with the new recommendations published in 2018 . The 19 key criteria were organized into three categories: (a) general recommendations, containing seven criteria, (b) universal principles, containing five criteria and (c) characteristics of a structured education programme, containing seven criteria.…”

Section: Methodsmentioning

confidence: 99%

“…Every intervention was assigned a global score out of 19 based on the number of recommendations met, followed by a second score by category identifying the weak points (Table 4). A second score <50% indicates the need to improve the educational programme in that category in relation to the ISPAD guidelines . The quality assessment was conducted by one coder and checked by three other coders.…”

Section: Methodsmentioning

confidence: 99%

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Pre‐empting the challenges faced in adolescence: A systematic literature review of effects of psychosocial interventions for preteens with type 1 diabetes

Velasco

Pals

Skinner

et al. 2020

Endocrino Diabet & Metabol

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Introduction: Numerous psychosocial interventions have been conducted in childrenand adolescents with type 1 diabetes, aiming to improve their self-management and autonomy acquisition. However, these tend to address family conflict and parental perspectives, and a scarce number of interventions explore the outcomes among preteens. This review examined the outcomes of psychosocial interventions for preteens with type 1 diabetes, as an under-researched field to date. Methods:A systematic literature review of intervention studies with randomized controlled trial design, targeting preteens with type 1 diabetes, was conducted.Six databases were searched for publication periods from 1995 to October 2019. Quality of the interventions according to the International Society for Pediatric andAdolescent Diabetes (ISPAD), as well as reporting and effect sizes, were assessed.Results: Twelve studies were selected, covering ten interventions. According to the topics identified, four of these interventions were categorized as self-care programmes, three as psychosocial programmes and three as mixed. All of the interventions, except for one, covered ≥50% of the ISPAD recommendations. Reporting adequacy was negative only in one intervention. Main outcomes were glycemic control and self-management, but effect sizes could only be calculated for half of the interventions with no overall significant effect. Conclusions:This review shows a lack of adequate psychosocial interventions targeting preteens with type 1 diabetes and actively involving them as participants. These intervention's educational programmes and methods should be standardized to guarantee successful results. New technologies and peer support implementation could be a promising pathway when designing these studies. K E Y W O R D Schildren and adolescents, education, psychological aspects, self-management, sociological aspects

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pre‐empting the challenges faced in adolescence: A systematic literature review of effects of psychosocial interventions for preteens with type 1 diabetes

Velasco

Pals

Skinner

et al. 2020

Endocrino Diabet & Metabol

View full text Add to dashboard Cite

show abstract

“…In a 2001 review evaluating the effectiveness of psychoeducational interventions in adolescents with T1DM, Hampson et al observed that most interventions were associated with a small (0.6%) and a non‐significant reduction in HbA1c levels . In recent years, several systematic reviews have been conducted to evaluate the metabolic impact of education programs on patients with T1DM . One of the reviews pointed out to a lack of well‐delineated studies and a great heterogeneity among the methodologies.…”

Section: Discussionmentioning

confidence: 99%

“…As in other studies, this one also showed metabolic improvement with the intervention at 12 months (0.11, 95% CI −0.28 to 0.50, P = .584) and 24 months (0.03, 95% CI −0.36 to 0.41, P = .891) of follow‐up. Colson et al revised 2528 studies assessing educational interventions for diabetes and identified 43 programs targeting youths with T1DM. The programs varied widely in terms of organization, procedure, and content.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effect of a compact vs a conventional, long-term education program on metabolic control in children and adolescents with type 1 diabetes: A pilot, randomized clinical trial

2019

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Background Effective education is considered essential for people with type 1 diabetes mellitus (T1DM) to adhere to a complex and long‐term medical regimen and to delay or prevent the onset of diabetes‐related complications. Objective We compared the effect of a compact, cost‐effective, education program (CEPT1) vs a long‐term program on the metabolic control of children and adolescents with T1DM. Methods Young people aged 8 to 21 years with T1DM were randomized to a short‐term (experimental) or an extensive education program (control). The experimental group participated in three sessions of 90 minutes, with one session per week, containing five short videos. The control group attended an extended program delivered through 45‐minute PowerPoint lectures, with one class every 3 months. The primary outcome was change in glycated hemoglobin A1c (HbA1c) levels from baseline to endpoint (baseline, 3, 6, 9, and 12 months). Results In total, 62 patients were randomized to the experimental (CEPT1) (n = 32) or control (n = 30) groups. Both groups showed comparable improvement in HbA1c levels at the end of 12 months (P = .183). In a per‐protocol analysis, the mean HbA1c level reduction was −2.3% (−2.6, −2.0) in the experimental group and − 1.8% (−2.0, −1.5) in the control group (P = .008). Conclusion CEPT1 was comparable with an extensive education program in reducing HbA1c levels. In a per‐protocol analysis, the CEPT1 was more effective than the control program in reducing HbA1c levels. CEPT1 is a simple and cost‐effective tool that can equally be used in settings with limited resources and specialized centers.

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“…Compared to the international debate concerning educational programs in diabetes education, many other interventions have been developed and evaluated. However, few programs seem to address psychosocial indicators [48].…”

Section: Discussionmentioning

confidence: 99%

Design of a Self-Management Program for Children Aged 6-12 Years with Type 1 Diabetes Mellitus at the Community Hospital Herdecke, Germany

et al. 2017

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Background: Children with type 1 diabetes mellitus (T1DM) must replace lacking endogenous insulin by daily insulin injections or insulin pumps. Standards of treatment include educational programs enabling self-management. The program ‘Herdecker Kids with Diabetes' (HeKiDi) is based on an anthroposophic understanding of the human being and intends to provide an individualized, patient-oriented approach to developing diabetes-related and comprehensive human competencies. Aim: Analysis of the HeKiDi program for children (6-12 years) with T1DM as the first part of an evaluation of a complex intervention. Methods: Ethnographic approach, following the Consolidated Criteria for Reporting Qualitative Research (COREQ), including field observations and interviews with responsible persons, content analysis of materials for determining the structure and the curriculum, presented according to the Template for Intervention Description and Replication (TIDieR). Results: The curriculum follows the standard but adds a learning circle between the child and the therapeutic team comprising 3 stages: (1) perception of the abilities and needs of the individual child supported by adult mentors themselves suffering from T1DM, (2) reflection within the therapeutic team, and (3) daily feedback to the child. Curricular Learning Objectives: Children feel recognized and supported in their individual developmental and diabetes-related competencies and develop motoric, artistic, communicative, and social skills to strengthen their self-efficacy and to understand T1DM as a lifelong awareness process. Conclusions: The curriculum including its associated learning goals and methods was presented. The program was explained and shown to be reproducible. Whether this program truly leads to better outcomes in regard to self-efficacy and hemoglobin A1c (HbA1c, glycated hemoglobin) and how parents and children perceive this will have to be assessed using a comparative interventional study.

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An Integrative Review of the Quality and Outcomes of Diabetes Education Programs for Children and Adolescents

Abstract: Various avenues can be considered to improve participant engagement in education programs and to align these programs more closely with international recommendations. Further research is required to enhance knowledge in this field.

Cited by 20 publications

References 61 publications

Pre‐empting the challenges faced in adolescence: A systematic literature review of effects of psychosocial interventions for preteens with type 1 diabetes

Pre‐empting the challenges faced in adolescence: A systematic literature review of effects of psychosocial interventions for preteens with type 1 diabetes

Comparison of the effect of a compact vs a conventional, long-term education program on metabolic control in children and adolescents with type 1 diabetes: A pilot, randomized clinical trial

Design of a Self-Management Program for Children Aged 6-12 Years with Type 1 Diabetes Mellitus at the Community Hospital Herdecke, Germany

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