Skip to main content

Table 1 Sources of evidence for D1 Now intervention development

From: Supporting self-management and clinic attendance in young adults with type 1 diabetes: development of the D1 Now intervention

Source Type of activity Overview of aims and findings Intervention development phase
‘It makes a difference, coming here’: A qualitative exploration of clinic attendance among young adults with type 1 diabetes [8] Qualitative research and theory development • Aimed to develop a theory explaining attendance at a hospital-based young adult diabetes clinic.
• Twenty-nine people (21 young adults with type 1 diabetes and eight service providers) from one hospital-based diabetes clinic were interviewed
• The importance of building strong relationships between young adults and service providers was a key finding of this work. Collaborative relationships between young adults and service providers increased the perceived value of attendance. Meeting multiple unfamiliar service providers had a negative impact on clinic attendance.
Preliminary evidence building
A systematic review of interventions to improve outcomes for young adults with type 1 diabetes [9] Systematic review • Aimed to synthesise the evidence regarding the effectiveness of interventions aimed at improving clinical, behavioural or psychosocial outcomes for young adults with T1D.
• Eighteen studies were included and categorised as follows: health services delivery (n = 4), group education and peer support (n = 6), digital platforms (n = 4).
• Continuity, support, education and tailoring of interventions to young adults were the most common themes across studies
• The effectiveness of these interventions on clinical, behavioural or psychosocial outcomes for young adults with T1D was unclear due to poor reporting and heterogeneity of study design.
• There is a lack of high-quality, well designed interventions aimed at improving health outcomes for young adults with T1D. The development of a new intervention is warranted. Possible components to the intervention could be continuity, support, education and tailoring of interventions to young adults.
BCW
Phase 1
Steps 1–4
Stakeholder perceptions of barriers & facilitators to self-management among young adults with type 1 diabetes: A qualitative analysis based on the COM-B model [19] Primary qualitative research • Aimed to understand the factors which influence young adults diabetes self-management and explore how services and support could be improved.
• Semi-structured interviews were conducted with diabetes healthcare providers (n = 15) and parents of young adults with T1D (n = 10). Three focus groups were conducted with young adults with T1D (n = 18).
• Thematic analysis was used to analyse the data, which was then further categorised using the framework of the COM-B model to identify the factors that influence self-management. All components of the COM-B model were relevant to self-management but physical and social opportunity factors, such as the influence of service providers seemed to be the dominant drivers.
• This study (alongside the systematic review) resulted in three focus areas for an intervention being identified. These were
o The way young adults are initially introduced to adult services
o Attendance at diabetes clinic appointments and contact between appointments
o Building relationships between young adults and service providers
• These focus areas went on to form the basis of the consensus meeting.
BCW
Phase 1
Steps 1–4
Embedding a user-centred approach in the development of complex behaviour change intervention to improve outcomes for young adults living with type 1 diabetes: The D1 Now study [4] International expert panel consensus meeting • Aimed to identify specific strategies to address the three focus areas mentioned above using the Behaviour Change Wheel (Michie et al., 2011).
• 18 experts including young adults with T1D, researchers, service providers and policy influencers took part in an Expert Panel meeting. Representative groups were formed and each team was asked to examine two of the three focus areas. The BCW was used to identify specific strategies which could be used.
• Seven key areas were identified including (1) strategies to facilitate continuity of care, (2) frequent review of young adult needs, (3) joint engagement of both young adults and service providers in diabetes management, (4) choice around when to transition to adult services, (5) engagement strategies, (6) availability of multiple modes of contact and engagement and (7) a flexible clinic appointment system.
BCW
Phase 2
Step 5
Embedding a user-centred approach in the development of complex behaviour change intervention to improve outcomes for young adults living with type 1 diabetes: The D1 Now study [4] YAP meetings Aimed to provide insight and information about the intervention context from a patient perspective
Aimed to get expert input and guidance into the intervention development, particularly around the operationalisation and mode of delivery of intervention components
BCW
Phase 1
Steps 1–4
Phase 2
Step 5
Phase 3
Steps 7 and 8