Letting the World See through Your Eyes: Using Photovoice to Explore the Role of Technology in Physical Activity for Adolescents Living with Type 1 Diabetes

Abstract

This paper qualitatively explores how technologies and physical activity are experienced by adolescents with type 1 diabetes. Type 1 diabetes is a life-threatening autoimmune condition, which is highly prevalent in young children. Physical activity is underutilised as part of treatment goals due to multifactorial challenges and lack of education in both the family setting and across society as a whole. Using photovoice methodology, 29 participants (parents and adolescents), individually or as dyads, shared and described in reflective journal format examples of technology and physical activity in their lives. In total, 120 personal photographs with accompanying narratives were provided. The data were thematically coded by the researcher and then collaboratively with participants. Four key themes (and 12 subthemes) were generated including: (i) benefits of technology; (ii) complexity and difficulty; (iii) emotional impact; (iv) reliance and risk. Findings demonstrate that current technology does not address the complex needs of adolescents with type 1 diabetes to enable participation in physical activity without life risk. We conclude from our findings that future technologies for supporting engagement in physical activity as part of diabetes management need to be: more interoperable, personalised and integrated better with ongoing education and support.

Challenges and Barriers of Physical Activity Among Pediatric Patients with Type 1 Diabetes Mellitus and Their Parents: A Systematic Review

“…The content of digital education, such as pump use or CGM, should be relevant to the technology tools applied. This situation may lead to variation in technology development in T1DM management (Morrow et al, 2022).…”

“…Four qualitative studies with an average number of 7, 14, and 116 T1DM participants and their parents were employed in this study (Alburno et al, 2022) (Collard et al, 2020;Fried et al, 2021;Morrow et al, 2022). We also enrolled three quantitative studies that involved 96 to 1,129 T1DM patients and their parents (Livny et al, 2020;Michaud et al, 2017;Roberts et al, 2021).…”

“…A study mentioned that their participants were aged between 17 to 18, however, did not state the age of the parents or patient's guardians (Alburno et al, 2022). However, six studies had mentioned the age of the patients and their parents, with the age range of the patient from 9 to 18 years (Collard et al, 2020;Fried et al, 2021;Livny et al, 2020;Michaud et al, 2017;Morrow et al, 2022;Roberts et al, 2021).…”

“…Further, five articles discovered the fear of hypoglycemia while being physically active as the leading factor that commonly impeded the physical activity intensity and frequency among pediatric and adolescents with T1DM (Collard et al, 2020;Fried et al, 2021;Livny et al, 2020;Michaud et al, 2017;Roberts et al, 2021). Findings also highlighted the lack of parental confidence in encouraging their children to be physically active due to the potency of unstable blood glucose level, parental responsibility in preparing adequate diet for their children with T1DM (Fried et al, 2021), the need of physical activity variation to stimulate physical exercise practice for children and adolescents with T1DM (Michaud et al, 2017), the presence of stigma from the surrounding about the physical capability of T1DM patients (Fried et al, 2021), adequate support from the family, school, and peer to adjust with the pace of type and intensity of the physical activity (Alburno et al, 2022;Livny et al, 2020), adequate level of knowledge about the physical activity recommendation and blood glucose level management control (Collard et al, 2020;Fried et al, 2021;Livny et al, 2020), and the unavailability of technology or tools to ensure an adequate level of physical activity practice and safety while being physically active as the perceived challenges and barriers in caring for patients with T1DM (Morrow et al, 2022 The current technology did not address the complex needs of adolescents with T1DM to support their active participation in physical exercise without risking their life and health safety.…”

Tecnologias Educacionais Para Promoção Da Saúde De Adolescentes Com Diabetes Mellitus Tipo 1.

“…No momento em que o diagnóstico é reconhecido, as crianças e adolescentes precisam receber informações, a fim de que possam elaborar o raciocínio acerca do processo saúde-doença e promover ações que visem o autocuidado (9) . (18,21) .…”