Development and feasibility testing of an intervention to support active lifestyles in youths with type 1 diabetes—the ActivPals programme: a study protocol

Abstract

BackgroundThe global incidence of type 1 diabetes is rising, and youths with type 1 diabetes continue to suffer poorer health than peers without diabetes. Evidence suggests youths with type 1 diabetes have physical activity (PA) levels well below the recommendations for health and have high levels of sedentary behaviour. An active lifestyle is therefore recommended to improve health. There is limited research showing effective lifestyle behaviour change in this population; therefore, an evidence gap exists between the need to promote physical activity in type 1 diabetes care and lack of understanding on how to do this. This protocol paper describes a feasibility and pilot study of the ActivPals programme—an intervention to support active lifestyles in youths with type 1 diabetes.Methods/designKey intervention components have been identified from preliminary work (individual and family focus, peer mentoring, technology integration and improved communication and understanding) and are being developed into a pragmatic randomised controlled trial (RCT) supported by recruitment pathways. A steering group of health care professionals and managers will refine the intervention to patient needs. A pilot trial is providing data on intervention implementation, acceptability and feasibility. Twenty youths with type 1 diabetes are being recruited and randomised into an intervention or control group. Physical activity is being measured objectively using the Actigraph GT3X+ monitor at baseline and 1-month follow-up. Contextual factors associated with intervention delivery are being explored.DiscussionThis study will contribute to the development of evidence-based, user-informed and pragmatic interventions leading to healthier lifestyles in youths with type 1 diabetes.

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

“…Use of CGM, rtCGM and iCGM should be widespread as they prevent the fear of exercise-induced hypoglycemia by constant observation of blood glucose trends which allow children to feel safer during physical activity [11]. Although preventive programs should be addressed in particular to children with chronic diseases, including T1D, it is also necessary to be aware that the problem of insufficient physical activity is also observed among children who are not affected by medical conditions [44]. Well-trained children and adolescents with well-controlled diabetes are able to perform high-intensity physical activity, just like their healthy peers.…”

Feasibility and pilot study of an intervention to support active lifestyles in youth with type 1 diabetes: The ActivPals study

“…A full recruitment strategy is provided as an appendix in the protocol paper . Recruitment of participants took place between January and March 2016 and finished when the target sample size was reached ( n = 20).…”

Lower objectively measured physical activity is linked with perceived risk of hypoglycemia in type 1 diabetes

“…Finally, studies exploring barriers to PA in children and adults with type 1 diabetes have identified the risk of hypoglycemia 13,33,34 The current study has inherent strengths and limitations. One major limitation of these analyses is the small sample size of CACTI participants who had accelerometer data;…”