Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Apr;40(4):e15035.
doi: 10.1111/dme.15035. Epub 2023 Jan 6.

Developments in the design and delivery of self-management support for children and young people with diabetes: A narrative synthesis of systematic reviews

Ian Litchfield  1 , Timothy Barrett  2   3 , Julian P Hamilton-Shield  4   5   6 , T H M Moore  4 , Parth Narendran  7   8 , Sabi Redwood  6 , Aidan Searle  9 , Suma Uday  3   10 , Jess Wheeler  6 , Sheila Greenfield  1
Affiliations
Review

Developments in the design and delivery of self-management support for children and young people with diabetes: A narrative synthesis of systematic reviews

Ian Litchfield et al. Diabet Med. 2023 Apr.

Abstract

Aims: Facilitated self-management support programmes have become central to the treatment of chronic diseases including diabetes. For many children and young people with diabetes (CYPD), the impact on glycated haemoglobin (HbA1c ) and a range of self-management behaviours promised by these programmes remain unrealised. This warrants an appraisal of current thinking and the existing evidence to guide the development of programmes better targeted at this age group.

Methods: Create a narrative review of systematic reviews produced in the last 3 years that have explored the impact on CYPD of the four key elements of self-management support programmes: education, instruction and advice including peer support; psychological counselling via a range of therapies; self-monitoring, including diaries and telemetric devices; and telecare, the technology-enabled follow-up and support by healthcare providers.

Results: Games and gamification appear to offer a promising means of engaging and educating CYPD. Psychological interventions when delivered by trained practitioners, appear to improve HbA1c and quality of life although effect sizes were small. Technology-enabled interactive diaries can increase the frequency of self-monitoring and reduce levels of HbA1c . Telecare provided synchronously via telephone produced significant improvements in HbA1c .

Conclusions: The cost-effective flexibility of increasing the reliance on technology is an attractive proposition; however, there are resource implications for digital connectivity in underserved populations. The need remains to improve the understanding of which elements of each component are most effective in a particular context, and how to optimise the influence and input of families, caregivers and peers.

Keywords: children and young people; glycaemic control; self-management behaviours; self-management support; type 1 diabetes; type 2 diabetes.

PubMed Disclaimer

References

REFERENCES

    1. Jonkman NH, Schuurmans MJ, Groenwold RHH, Hoes AW, Trappenburg JCA. Identifying components of self-management interventions that improve health-related quality of life in chronically ill patients: systematic review and meta-regression analysis. Patient Educ Couns. 2016;99(7):1087-1098. doi:10.1016/j.pec.2016.01.022
    1. Nolte S, Elsworth GR, Sinclair AJ, Osborne RH. The extent and breadth of benefits from participating in chronic disease self-management courses: a national patient-reported outcomes survey. Patient Educ Couns. 2007;65(3):351-360.
    1. Schulman-Green D, Jaser S, Martin F, et al. Processes of self-management in chronic illness. J Nurs Scholarsh. 2012;44(2):136-144.
    1. Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1-7.
    1. Riegel B, Westland H, Iovino P, et al. Characteristics of self-care interventions for patients with a chronic condition: a scoping review. Int J Nurs Stud. 2021;116:103713. doi:10.1016/j.ijnurstu.2020.103713

Publication types

LinkOut - more resources