Experiences of transition to adulthood and transfer to adult care in young adults with type 1 diabetes: A qualitative study

Olsson, Sara; Otten, Julia; Blusi, Madeleine; Lundberg, Elena; Hörnsten, Åsa

doi:10.1111/jan.15740

Cited by 3 publications

(1 citation statement)

References 31 publications

(112 reference statements)

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“…I wonder what new resources and strategies I’ll need when I go away to college, travel without my parents, advocate for myself in my future jobs and career, and take financial responsibility for diabetes-related expenses as I move off of my parents’ health insurance plan in the next decade. A few studies have shown that I am not the only teen thinking about these issues ( 8 , 9 ). More studies are needed to identify opportunities to intervene.…”

Section: Continuing To Thrive Into Adulthoodmentioning

confidence: 99%

What Do Adolescents With Type 1 Diabetes Need to Thrive? Perspective of a 16-Year-Old With 4 Years of Experience Living With Type 1 Diabetes

Bekelman

2023

Diabetes Spectrum

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Section: Continuing To Thrive Into Adulthoodmentioning

confidence: 99%

What Do Adolescents With Type 1 Diabetes Need to Thrive? Perspective of a 16-Year-Old With 4 Years of Experience Living With Type 1 Diabetes

Bekelman

2023

Diabetes Spectrum

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Meeting the Needs of Emerging Adults With Type 1 Diabetes Living in a Rural Area With Mobile Health Interventions: Focus Group Study

Idalski Carcone,

Holtz,

Reardon

et al. 2024

JMIR Form Res

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Background Emerging adults (EAs; age 18-30 years) with type 1 diabetes (T1D) have more challenges with diabetes management and glycemic control than other age groups. Living in a rural community introduces additional unique diabetes care challenges due to limited access to specialty care and ancillary support services. Yet, few interventions have been developed to improve diabetes management in rural-dwelling EAs with T1D. Objective This study aimed to understand the diabetes management experiences of older adolescents and EAs (age 16-25 years) with T1D living in a rural area and to assess their perceptions of the acceptability of 4 fully automated mobile health (mHealth) interventions to support diabetes management. Methods EAs were identified by clinical staff through convenience sampling. In total, 8 EAs participated in 1 focus group and 1 EA completed an individual interview; all data were collected over Zoom. Facilitators explored EAs’ experiences living in a rural community with T1D and discussed EAs’ impressions of, feedback on, and recommendations for improving 4 mHealth interventions to meet the specific needs of EAs with T1D living in rural communities. Discussions were transcribed and analyzed using conventional content analysis. Results In total, 9 EAs (aged 18.8, SD 2.7 years; 5, 56% men; 8, 89% White) with a duration of diabetes of 8.6 (SD 4.3) years participated. They described experiences with diabetes stigma (attributing diabetes to poor lifestyle choices) and feelings of self-consciousness (hyperawareness) in their rural communities. They attributed these experiences to the small size of their communities (“everyone knows”) and community members’ lack of knowledge about diabetes (unable to differentiate between type 1 and type 2 diabetes). In contrast, EAs reported high levels of social support for diabetes and diabetes care from family, friends, and other community members, but low support for medical needs. The location of their diabetes care providers and the limited accessibility of diabetes-specific and general medical care services in their local community created a challenging medical care context. Overall, EAs found mHealth interventions appealing due to their digital delivery and highlighted features that increased accessibility (voiceovers and simple, jargon-free language), individualization (ability to tailor intervention content and delivery), and applicability to their own lives and other EAs with T1D (relatability of vignettes and other content). EAs suggestions for improving the interventions included more opportunities to tailor the interventions to their preferences (greater frequency and duration, ability to adapt content to emerging needs), increasing opportunities for peer support within the interventions (friend and significant other as identified support person, connecting with peers beyond their local community), and making the tone of intervention components more casual and engaging. Conclusions mHealth interventions aligned with EAs’ needs and preferences are a promising strategy to support EAs in communities where social support and resources might be limited. Trial Registration N/A, not a clinical trial

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Meeting the Needs of Emerging Adults With Type 1 Diabetes Living in a Rural Area With Mobile Health Interventions: Focus Group Study (Preprint)

Idalski Carcone,

Holtz,

Reardon

et al. 2024

Preprint

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BACKGROUND Emerging adults (age 18-30) with type 1 diabetes (T1D) have more challenges with diabetes management and glycemic control compared to other age groups. Living in a rural community introduces additional unique diabetes care challenges due to limited access to specialty care and ancillary support services. Yet, few interventions have been developed to improve diabetes management in rural-dwelling EAs with T1D. OBJECTIVE The goal of this research was to understand the diabetes management experiences of older adolescents and emerging adults (EAs; age 16-25 years) with type 1 diabetes living in a rural area and to assess their perceptions of the acceptability of four mHealth interventions to support diabetes management. METHODS Nine EAs [18.8 (± 2.7) years, 56% male, 89% White, duration of diabetes 8.6 (± 4.3) years] were identified by clinical staff through convenience sampling. Eight EAs participated in a single focus group and one completed an individual interview over Zoom. Discussions were transcribed and analyzed using conventional content analysis. RESULTS EAs described experiences with diabetes stigma and feelings of self-consciousness in their rural communities. They attributed these experiences to the small size of their communities and community members’ lack of knowledge about diabetes. EAs also reported social support for diabetes and diabetes care from family, friends, and other community members. Meeting their diabetes medical care needs was a challenge due to their diabetes care providers’ location and the limited accessibility of diabetes-specific and general medical care services in their local community. Overall, emerging adults found the four eHealth interventions applicable to their diabetes needs and appreciated the ability to tailor aspects of the interventions to their preferences. EAs suggestions for improving the interventions included more opportunities to tailor the interventions to their preferences, increasing opportunities for peer support within the interventions, and making the tone of the intervention more lively. CONCLUSIONS mHealth intervention aligned with EAs’ needs and preferences is a promising strategy to support EAs in communities where social support and resources might be limited. CLINICALTRIAL N/A, not an RCT

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Experiences of transition to adulthood and transfer to adult care in young adults with type 1 diabetes: A qualitative study

Cited by 3 publications

References 31 publications

What Do Adolescents With Type 1 Diabetes Need to Thrive? Perspective of a 16-Year-Old With 4 Years of Experience Living With Type 1 Diabetes

What Do Adolescents With Type 1 Diabetes Need to Thrive? Perspective of a 16-Year-Old With 4 Years of Experience Living With Type 1 Diabetes

Meeting the Needs of Emerging Adults With Type 1 Diabetes Living in a Rural Area With Mobile Health Interventions: Focus Group Study

Meeting the Needs of Emerging Adults With Type 1 Diabetes Living in a Rural Area With Mobile Health Interventions: Focus Group Study (Preprint)

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