Understanding adolescent and parent acceptability and feasibility experience in a large Type 1 diabetes mellitus behavioural trial.

Autor: Grossoehme, D. H., Smith, E., Standiford, D., Morwessel, N., Kichler, J., Maahs, D. M., Driscoll, K., Seid, M.
Předmět:
Zdroj: Diabetic Medicine; Jul2020, Vol. 37 Issue 7, p1134-1145, 12p, 4 Charts
Abstrakt: Aims: Using an 18‐month, multisite randomized control trial as an exemplar, the aim of this study was to identify themes related to adolescent and parental feasibility and acceptability for participation in large behavioural trials designed to improve adolescents' Type 1 diabetes self‐management. Methods: Thematic analysis methodology was used to develop themes describing factors related to acceptability and feasibility. Results: Based on a sample of interviews (N = 72), factors contributing to intervention acceptability and feasibility were identified. Aspects of acceptability included: a framework for goal‐setting, the coach as a non‐judgemental listener, perception of an ongoing benefit to participation and the delivery mode. Aspects of feasibility included: participants' altruism to help adolescents with Type 1 diabetes; pre‐enrolment preparation for intervention content and duration; and the option of remote intervention delivery via telephone or video, which minimized travel time and costs. In addition, participants described positive outcomes including improvements in behaviour, Type 1 diabetes self‐management behaviours and parent–adolescent communication, and emotion–attitude changes. Participants also described potential revisions that may inform future trials. Conclusions: Acceptability and feasibility of behavioural interventions with adolescents with chronic illness have multifactorial dimensions. While empowering adolescent self‐management, parental support is also an under‐appreciated aspect to consider. Potential revisions were identified for subsequent behavioural trials. What's new?: Diabetes self‐management does not consistently meet target HbA1c values. Large‐scale behavioural trials with adolescents present challenges to their feasibility and acceptability.An 18‐month behavioural intervention trial is both acceptable and feasible for many adolescents and their parents.Adolescent acceptability was demonstrated by their willingness to develop goals and use problem‐solving techniques.Adolescents and parents reported outcomes of positive emotion–attitude changes and improvements in behaviour, Type 1 diabetes self‐management and parent–adolescent communication.Adolescents appreciated that they were able to set their own goals, but some parents wanted more directive coaching. To rectify this discrepancy, future trials could require goals to be related to diabetes management rather than being completely open‐ended, while still allowing the adolescent autonomy to choose any goal within that broad category.Some parents wanted more guidance to improve their skills in supporting adolescents' self‐management and may benefit from parent‐only sessions.Some adolescents felt the goal‐setting process was repetitious. Therefore, a less‐frequent, more‐varied goal‐setting process would be recommended for future trials. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index