“Having diabetes shouldn’t stop them”: healthcare professionals’ perceptions of physical activity in children with Type 1 diabetes

Abstract

BackgroundHealthcare professionals (HCP) working with children who have Type 1 Diabetes Mellitus (T1DM) have an important role in advising about and supporting the control of blood glucose level in relation to physical activity. Regular physical activity has known benefits for children with T1DM, but children with chronic conditions may face barriers to participation. The perceptions of HCPs were explored in an effort to understand what influences physical activity in children with T1DM and to inform the practice of those working with children who have T1DM.MethodsSemi-structured interviews with 11 HCPs involved in the care of children with T1DM in the UK were conducted. Interviews were recorded, transcribed verbatim and data were analysed using thematic analysis.ResultsThe factors perceived to influence participation in physical activity are presented as five major themes and eleven sub-themes. Themes included the positive influence of social support, the child’s motivation to be active, the potential for formal organisations such as school and diabetes clinic to support physical activity, the challenges faced by those who have T1DM and the perceived barriers to HCPs fulfilling their role of promoting physical activity.ConclusionsHealthcare professionals recognised their role in helping children with T1DM and their parents to incorporate physical activity into diabetes management and everyday life, but perceived barriers to the successful fulfilment of this role. The findings highlight the potential for clinical and non-clinical supportive systems to be sensitive to these challenges and facilitate children’s regular participation in physical activity.

Feasibility and safety of a group physical activity program for youth with type 1 diabetes

“…Each session consisted of 35 minutes of MVPA followed by 45 minutes of discussion of relevant topics. The intervention targeted two identified barriers to MVPA for adolescents with type 1 diabetes . First, it augmented supervised MVPA exercises and games with diabetes self‐management education (DSME) and glucose self‐monitoring activities so that adolescents could develop skill controlling their own glucose around enjoyable MVPA activities.…”

“…Among the challenges of engaging in regular MVPA for adolescents with type 1 diabetes are the need for monitoring blood glucose levels and adjusting diet and insulin before, during, and after MVPA. Adolescents, parents, and healthcare providers have reported that these responsibilities are carried out without adequate support resources . Adolescence is a period of transition in type 1 diabetes management, in which responsibility for diabetes management shifts from being family‐centered to being more autonomous .…”

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

“…Other important aspects of ActivPals include tailoring to the participant’s baseline activity, activity preferences, and local opportunities using role modeling, peer support, and self-monitoring devices. Supporting Kids with Diabetes in Physical Activity (SKIP) and Steps to Active Kids with Diabetes (STAK-D) are other interventions that have been developed [94]. Both are also based on social cognitive theory and include educational materials, physical activity diaries, and goal-setting strategies.…”

Feasibility of an online intervention (STAK-D) to promote physical activity in children with type 1 diabetes: protocol for a randomised controlled trial

“…Both participating sites operate under the same general standardisation of care; they both adhere to Global IDF/ISPAD Clinical Practice Consensus Guidelines [41], NICE guidelines for clinical care of diabetes in children and young people [42], and the UK National Health Service (NHS) national diabetes best practice tariff, which specifies requirements for the service. Quantifying usual care with regards physical activity is difficult, although our previous qualitative research suggests that lifestyle physical activity advice is limited in the current clinical care of children with T1DM [18, 24]. Usual care at each site will be described as part of this feasibility study following recommendations by Erlen et al [43]; this will allow for accurate definition of usual care in future trial design.…”

“…Self-efficacy in particular is a critical element in increasing and sustaining physical activity levels [21, 23]. Parents have pointed to a lack of ‘digestible’ resources for physical activity promotion and health care professionals (HCPs) have similarly identified a lack of age-appropriate, evidence-based resources [24]. Consequently, intervention should be age-appropriate and build children’s self-efficacy for physical activity which is essential to enable sustained lifelong behavioural changes.…”