Exploring the views of adolescents with type 1 diabetes on digital mental health interventions: What functionality and content do they want?

Abstract

Background Adolescents with type 1 diabetes (T1D) experience higher rates of psychological disorders compared with their healthy peers. As poor psychological health has been associated with suboptimal glycaemic control and more frequent complications, there is an urgent need to develop more ‘clinically usable’ interventions. Digital mental health interventions offer unique advantages compared with in‐person interventions; however, what adolescents with T1D want in terms of content and functionality is poorly understood. Accordingly, the current study conducted focus groups to examine the views of adolescents with T1D regarding digital mental health interventions. Methods Four focus groups were conducted, including 16 adolescents with T1D, ranging from 13 to 17 years in age (69% female). Transcripts were analysed using directed content analysis to examine (1) ‘what adolescents dislike about existing digital mental health interventions?’ and (2) ‘what adolescents want in future digital mental health interventions?’. Results Findings provide a preliminary understanding of what adolescents dislike and also the type of content and functional features, which may be important to include in digital mental health programs for this population, such as a peer support feature (reported by 16 of 16), emotion and diabetes check‐in feature (11 of 16) and diabetes‐relevant content (12 of 16). Conclusions Early data suggest that digital mental health interventions should include a significant peer support element, diabetes‐relevant content and examples, and check‐in on their mental health and diabetes self‐management regularly, while avoiding fixed responses or modules and non‐age‐appropriate content. Based on these findings, a digital intervention is currently being developed.

Improving the Well-being of Adolescents With Type 1 Diabetes During the COVID-19 Pandemic: Qualitative Study Exploring Acceptability and Clinical Usability of a Self-compassion Chatbot

“…However, the COMPASS chatbot uses some instances of artificial intelligence to identify emotions; whether diabetes management is suboptimal or optimal; and risk words to deliver personalized, empathetic, and relevant responses and adequate information to connect with further crises and mental health support services. Further format and functionality features of the current prototype version were informed by suggestions from a previous qualitative study conducted by our research team, which explored the functionality and content that adolescents with T1D wanted to see in future digital mental health programs [ 29 ].…”

“…A target sample size of approximately 15 to 20 adolescents with T1D (aged between 12 and 16 years) and 10 to 15 diabetes health care professionals were chosen as an achievable recruitment target. Informed by earlier qualitative work in this area [ 29 ] and reviews of qualitative research [ 41 ], we estimated that this sample size would allow data saturation to occur. However, if data saturation was not achieved, an ethical amendment would have been applied to expand the number of participants.…”

“…Adolescents who had participated in previous research [ 28 , 29 ] and had consented to be conducted for future research projects were invited to participate via email on a first-in-first-serve basis. Concurrently, study flyers were given to eligible participants in pediatric diabetes clinics in the Auckland region by endocrinologists, PH and CJ, who were involved in the study, and study flyers were posted in web-based communities, such as Diabetes Youth Auckland and Type 1 Diabetes Youth in Aotearoa New Zealand Facebook pages.…”

“…Our previous research found self-compassion to be an acceptable approach to improving mental and physical health in adolescents with T1D; however, face-to-face delivery demonstrated serious feasibility issues [ 28 ]. Our follow-up qualitative research, exploring perceptions regarding a possible digital adaption, demonstrated that a chatbot adaption was the preferred digital platform among adolescents with T1D [ 29 ].…”

The power of equality

“…It is essential that the digital 'push' meets the clinical and user 'pull'. In this issue of Diabetic Medicine, the views of adolescents on their desired content and functionality for a digital mental health intervention are explored, 4 revealing clear thoughts on peer support, diabetes content, flexible content and age appropriateness. This enables clear user-driven design of an intervention clearly targeted at a high-risk group.…”