Table 9 Summary of quantitative and qualitative data for feasibility outcomes
| RE-AIM themes | Outcomes (patients) | Survey (diabetes team) | Focus groups (diabetes team) |
|---|---|---|---|
| Reach |
• Uptake better than expected (n = 89) • Twice as many females to males recruited • Low accrual rates (n = 4) • Response rates 49.4% • Average age of completers and non-completers 14.3/14.5 years respectively • More female than male completers: ratio ~2:1 |
• All reported technological capability in clinical practice • Some ambivalence re: using technology in patients’ education • No paediatric teaching qualifications |
• Ideal time to integrate ADNAT into clinical practice • Offers a technological approach to care in line with policy and young peoples’ needs • Fits within BPT’s education criterion/peer review process. • Potential as an audit tool questioned given its focus on 12–18 years only • Training to use activity learning to support a team approach and include expert users of ADNAT |
| Effectiveness (potential and perceived) |
• Completers—post-ADNAT mean HbA1C level 5.42 mmol/mol’s lower than non-completers at 6 months • ADNAT judged to be effective at each of the 8 different stages of the transtheoretical change cycle |
• ADNAT’s system and information quality judged as good • ADNAT judged to be effective, practical, useful and efficient • Value to patients perceived to be linked to parental support, age and previous diabetes education |
• Time between patients’ completions and reviews with practitioners in clinic/home critical to effectiveness • ADNAT perceived to promote behaviour change • Primary outcomes to include glycaemic control and quality of life, with qualitative data to illuminate wider effects of education |
| Adoption |
• Majority of patients completed ADNAT in clinic • All felt that patients, their families and the Diabetes Network would want ADNAT to be used • Majority intend to use ADNAT in the future |
• Lead clinician support essential • Requires a team approach to implementation • Needs to be tailored to fit each team • Scoring, traffic light feedback, drop-down menus and navigation commands support tailored health care planning but some concern re: patients’ responses to traffic light system | |
| Implementation/maintenance |
• Access to Wi-Fi in clinics poor/negligible • No data protection issues reported • Need for: – Improved Wi-Fi access and IPads – Section for patients to ask for immediate feedback/help from diabetes teams – Access to short on-line patient reports |
• Access to on-line technical support needed • Use of Ipads with SIM cards to overcome Wi-Fi problems in clinics • To secure clinical feasibility: – Home completions prior to clinic visits – Consents taken in clinic – Instructions sent in appointment letters – Automatic text reminders |