School-based intervention to improve self management among adolescents with Type 1 diabetes mellitus

Abstract

Background: Type 1 diabetes mellitus (T1DM) is a long-term condition that can lead
to serious complications in adolescents, due to poor metabolic control. Self
management is a key component in diabetes care. However, this can be challenging in
adolescence, as this period includes physical, psychosocial, and emotional strains. As
with other adolescents, those with T1DM spend long hours in school. Therefore, they
are expected to manage their complicated diabetes requirements while they are
engaging in other school activities. Consequently, the school is a critical environment
for adolescents with T1DM. Thus, school-based interventions intended to improve self
management among adolescents with T1DM should be available in a form suitable to
the understanding and age-specific demands of adolescents through recognising their
needs and priorities. Adolescents should have the chance to make informed decisions
about their treatment and care, in cooperation with their health care specialists.

Aim: to develop a school-based intervention to promote self-management (i.e. physical
and psychosocial management) among adolescents with T1DM aged 11 to 15 by
exploring their needs and priorities regarding the intended intervention.

Method: exploratory, qualitative research using an applied thematic analysis, structured
into four stages. In the first stage, face-to-face semi-structured interviews were
conducted with 18 adolescents to gain more understanding of their needs and priorities, in order to enhance self-management in schools. The second stage involved using the
findings from the first stage to guide and shape the intended intervention. In this stage,
the intervention mapping framework was used to guide the development of the intended
intervention. In the third stage, health care professionals from the paediatric diabetic
team were interviewed to provide recommendations about the scientific content and
relevancy of the developed intervention based on the findings of the study and their
expert views. Finally, data regarding the appropriateness of the developed intervention’s
content and materials were collected from another ten adolescents with T1DM.

Results: the findings of the first stage revealed how adolescents with T1DM wanted to
be supported in school. They wanted their peers and teachers at school to know more
about T1DM. Thematic analysis was used to identify the content of the intervention.
The data collected from the first stage has identified specific information that, if known
by peers and teachers, can reduce some of the physical and psychosocial challenges and
consequently improve self-management among adolescents with T1DM in a school
setting. The findings from the first stage were used to develop the intervention
(animated video). Intervention mapping protocol was utilised to ensure a systematic and
evidence-based approach for the development of the intervention. The results of the
third and fourth stages of this study indicated that the developed intervention was
relevant and appropriate to be used in school.

Conclusion: the findings of this study helped to develop well-informed evidence-based
interventions, ready for pilot testing in the future, that can enhance self-management in
adolescents with T1DM in school settings.

More information

Identifiers

ORCID for Raya, Said Al Habsi: orcid.org/0000-0001-9321-1445

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