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Table 9 Summary of quantitative and qualitative data for feasibility outcomes

From: A mixed methods study to evaluate the feasibility of using the Adolescent Diabetes Needs Assessment Tool App in paediatric diabetes care in preparation for a longitudinal cohort study

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