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. 2023 Jul;12(3):e002361.
doi: 10.1136/bmjoq-2023-002361.

Implementation and evaluation of a longitudinal diabetes educational programme for adolescents

Kristina Loreta Pabedinskas  1 , Jennilea Courtney  2 , Nicholas Barrowman  1   2 , Sarah Zankar  1 , Christine Richardson  3 , Liz Stevens  4 , Ellen B Goldbloom  1   4 , Sarah E Lawrence  1   4 , Caroline Zuijdwijk  1   4 , Margaret L Lawson  1   4 , Marie-Eve Robinson  1   4 , Saunya Dover  3 , Alexandra Ahmet  5   4
Affiliations

Implementation and evaluation of a longitudinal diabetes educational programme for adolescents

Kristina Loreta Pabedinskas et al. BMJ Open Qual. 2023 Jul.

Abstract

Introduction: International guidelines recommend structured and continuous educational programmes to expand diabetes knowledge and self-efficacy in youth. To address these recommendations within a paediatric diabetes clinic, we conducted a three-phase quality improvement project aimed at improving adolescents' confidence in diabetes self-management skills.

Methods: In phase 1, the Diabetes Learning Centre (DLC), an educational programme for adolescents with type 1 diabetes (T1D) ages 13-17 years, was developed and implemented. Programme feasibility was evaluated through programme attendance rates. Phase 2 aimed to guide ongoing programme development and optimisation. DLC attendees rated their baseline confidence in overall and individual T1D self-management skills on a 5-point Likert scale. Patient characteristics were summarised using descriptive statistics and the association between patient characteristics and overall confidence in T1D self-management was evaluated. Phase 3 used patient surveys to evaluate patient satisfaction and reported change in confidence in self-management skills following DLC attendance.

Results: In phase 1, 232 (81%) of eligible adolescents attended the DLC during the study period. In phase 2, median overall confidence in diabetes management on a Likert scale (0-4) was 3, representing 'quite confident', although confidence was low in some essential self-management skills. Higher confidence was associated with lower HbA1c (p<0.001). In phase 3, 77 (85%) of participants reported high levels of satisfaction with the DLC. 106 (82%) of completed worksheets were associated with improved confidence in the diabetes self-management skill addressed.

Conclusions: Implementation of a longitudinal T1D educational model was feasible with good uptake in an existing T1D programme. While confidence at baseline was quite high for overall T1D self-management, it was low in some essential self-management skills, highlighting the need for this programme and specific educational gaps. Adolescents reported improvements in confidence and high levels of satisfaction following DLC attendance. Our model provides a replicable programme template to address longitudinal education needs.

Keywords: Diabetes mellitus; Education; Paediatrics; Quality improvement; Transition to Adult Care.

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Conflict of interest statement

Competing interests: The authors declare the following financial interests/personal relationships which may be considered as competing interests: M-ER: Ascendis Biopharma and Ipsen Biopharmaceuticals study grants to institution, and Ultragenyx and Ipsen Biopharmaceuticals consultancy fees to institution. SEL and CZ: Tandem Diabetes Care study grant to institution. MLL, EBG and CZ: Medtronic study grant to institution. EBG is a member (current Chair) of the Epic International Specialty Steering Board for Pediatric Endocrinology - this is an unpaid, elected (by peers) position.

Figures

Figure 1
Figure 1
Confidence in diabetes related skills. Likert responses to ‘How confident are you in your ability to …’. Response rate for mini dose glucagon 95%, managing diabetes safely if drinking alcohol 76% and driving safely with diabetes 20% of the total study population. Response rate for all other skills 97%–100%.
Figure 2
Figure 2
Change in self-reported confidence in diabetes self-management skills by worksheet. Likert responses to ‘After completing the worksheet, how has your confidence in the topic/skill changed?’. n=number of worksheets completed.
See this image and copyright information in PMC

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