DOI QR코드

DOI QR Code

Healthcare coaching program for youth with type 1 diabetes in South Korea: a pilot study

  • Dae Eun Lee (College of Nursing, Pusan National University) ;
  • Haejung Lee (College of Nursing.Research Institute of Nursing Science, Pusan National University) ;
  • Chong Kun Cheon (Department of Pediatrics, College of Medicine, Pusan National University Children's Hospital) ;
  • Ju Young Yoon (Department of Pediatrics, College of Medicine, Pusan National University Children's Hospital)
  • Received : 2023.09.23
  • Accepted : 2024.01.10
  • Published : 2024.01.31

Abstract

Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

Keywords

Acknowledgement

This work was supported by a 2-Year Research Grant of Pusan National University.

References

  1. International Diabetes Federation (IDF). Type 1 diabetes [Internet]. 2023 [cited 2023 September 27]. Available from: https://idf.org/about-diabetes/type-1-diabetes/ 
  2. Baechle C, Stahl-Pehe A, Prinz N, Meissner T, Kamrath C, Holl RW, et al. Prevalence trends of type 1 and type 2 diabetes in children and adolescents in North Rhine-Westphalia, the most populous federal state in Germany, 2002-2020. Diabetes Research and Clinical Practice. 2022;190:109995. https://doi.org/10.1016/j.diabres.2022.109995 
  3. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 14. Children and adolescents: standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S230-S253. https://doi.org/10.2337/dc23-s014 
  4. Seckold R, Howley P, King BR, Bell K, Smith A, Smart CE. Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets. BMJ Open Diabetes Research & Care. 2019;7(1):e000663. https://doi.org/10.1136/bmjdrc-2019-000663 
  5. Yetim A, Alikasifoglu M, Bas F, Eliacik K, Cig G, Erginoz E, et al. Glycemic control and health behaviors in adolescents with type 1 diabetes. Turkish Journal of Pediatrics. 2018;60(3):244-254. https://doi.org/10.24953/turkjped.2018.03.003 
  6. Roberts AJ, Law JR, Suerken CK, Reboussin BA, Lawrence JM, Taplin CE, et al. Alcohol consumption patterns in young adults with type 1 diabetes: the SEARCH for diabetes in youth study. Diabetes Research and Clinical Practice. 2020;159:107980. https://doi.org/10.1016/j.diabres.2019.107980 
  7. Skog O, Korsgren O. Aetiology of type 1 diabetes: physiological growth in children affects disease progression. Diabetes, Obesity & Metabolism. 2018;20(4):775-785. https://doi.org/10.1111/dom.13144 
  8. Majumder E, Cogen FR, Monaghan M. Self-management strategies in emerging adults with type 1 diabetes. Journal of Pediatric Health Care. 2017;31(1):29-36. https://doi.org/10.1016/j.pedhc.2016.01.003 
  9. Vogels E, Gelles-Watnick R, Massarat N. Teens, social media and technology 2022 [Internet]. 2022 [cited 2023 November 11]. Available from: https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/ 
  10. Wang X, Shu W, Du J, Du M, Wang P, Xue M, et al. Mobile health in the management of type 1 diabetes: a systematic review and meta-analysis. BMC Endocrine Disorders. 2019;19(1):21. https://doi.org/10.1186/s12902-019-0347-6 
  11. Alfonsi JE, Choi EEY, Arshad T, Sammott SS, Pais V, Nguyen C, et al. Carbohydrate counting app using image recognition for youth with type 1 diabetes: pilot randomized control trial. JMIR mHealth and uHealth. 2020;8(10):e22074. https://doi.org/10.2196/22074 
  12. Barnes TL, Lee S, Thompson N, Mullen K, Chatterton P, Gandrud L. Barriers to glucose testing and attitudes toward mobile app and device use in a large cohort of T1D pediatric patients: implications for diabetes management. Journal of Diabetes Science and Technology. 2018;12(6):1246-1247. https://doi.org/10.1177/1932296818794706 
  13. Park G, Lee H, Khang AR. The development of automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. Journal of Korean Academy of Nursing. 2022;52(5):535-549. https://doi.org/10.4040/jkan.22046 
  14. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine. 2010;152(11):726-732. https://doi.org/10.7326/0003-4819-152-11-201006010-00232 
  15. Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Statistical Methods in Medical Research. 2016;25(3):1057-1073. https://doi.org/10.1177/0962280215588241 
  16. Kirwan M, Vandelanotte C, Fenning A, Duncan MJ. Diabetes self-management smartphone application for adults with type 1 diabetes: randomized controlled trial. Journal of Medical Internet Research. 2013;15(11):e235. https://doi.org/10.2196/jmir.2588 
  17. Boo S, Ahn Y, Lee JE, Kang N, Kang H, Sohn M. Diabetes-specific quality of life of Korean children and adolescents with type 1 diabetes. International Journal of Nursing Knowledge. 2016;27(2):62-69. https://doi.org/10.1111/2047-3095.12075 
  18. Iannotti RJ, Schneider S, Nansel TR, Haynie DL, Plotnick LP, Clark LM, et al. Self-efficacy, outcome expectations, and diabetes self-management in adolescents with type 1 diabetes. Journal of Developmental and Behavioral Pediatrics. 2006;27(2):98-105. https://doi.org/10.1097/00004703-200604000-00003 
  19. Shamah-Levy T, Rodriguez-Ramirez S, Gaona-Pineda EB, Cuevas-Nasu L, Carriquiry AL, Rivera JA. Three 24-hour recalls in comparison with one improve the estimates of energy and nutrient intakes in an urban Mexican population. Journal of Nutrition. 2016;146(5):1043-1050. https://doi.org/10.3945/jn.115.219683 
  20. U.S. Department of Agriculture (USDA), U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2020-2025. 9th ed. USDA; 2020. p. 71-91. 
  21. Dudek SG. Nutrition essentials for nursing practice. 7th ed. Lippincott Williams & Wilkins; 2013. p. 497-534. 
  22. Kook SH, Varni JW. Validation of the Korean version of the pediatric quality of life inventory 4.0 (PedsQL) generic core scales in school children and adolescents using the Rasch model. Health and Quality of Life Outcomes. 2008;6:41. https://doi.org/10.1186/1477-7525-6-41 
  23. Lee EH, Lee SJ, Hwang ST, Hong SH, Kim JH. Reliability and validity of the Beck Depression Inventory-II among Korean adolescents. Psychiatry Investigation. 2017;14(1):30-36. https://doi.org/10.4306/pi.2017.14.1.30 
  24. Kim JH, Lee EH, Hwang ST, Hong SH. Manual for the K-BDI-II. Korea Psychology; 2015. p 2. 
  25. Elo S, Kyngas H. The qualitative content analysis process. Journal of Advanced Nursing. 2008;62(1):107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x 
  26. Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Services Research. 2013;48(6 Pt 2):2134-2156. https://doi.org/10.1111/1475-6773.12117 
  27. Butte NF, Watson KB, Ridley K, Zakeri IF, McMurray RG, Pfeiffer KA, et al. A youth compendium of physical activities: activity codes and metabolic intensities. Medicine and Science in Sports and Exercise. 2018;50(2):246-256. https://doi.org/10.1249/mss.0000000000001430 
  28. Soufi A, Mok E, Henderson M, Dasgupta K, Rahme E, Nakhla M. Association of stigma, diabetes distress and self-efficacy with quality of life in adolescents with type 1 diabetes preparing to transition to adult care. Diabetic Medicine. 2024;41(1):e15159. https://doi.org/10.1111/dme.15159 
  29. Kristensen LJ, Birkebaek NH, Mose AH, Berg Jensen M, Thastum M. Multi-informant path models of the influence of psychosocial and treatment-related variables on adherence and metabolic control in adolescents with type 1 diabetes mellitus. PLoS One. 2018;13(9):e0204176. https://doi.org/10.1371/journal.pone.0204176 
  30. Pandey A, Hale D, Das S, Goddings AL, Blakemore SJ, Viner RM. Effectiveness of universal self-regulation-based interventions in children and adolescents: a systematic review and meta-analysis. JAMA Pediatrics. 2018;172(6):566-575. https://doi.org/10.1001/jamapediatrics.2018.0232 
  31. Goyal S, Nunn CA, Rotondi M, Couperthwaite AB, Reiser S, Simone A, et al. A mobile app for the self-management of type 1 diabetes among adolescents: a randomized controlled trial. JMIR mHealth and uHealth. 2017;5(6):e82. https://doi.org/10.2196/mhealth.7336 
  32. Lansing AH, Stanger C, Budney A, Christiano AS, Casella SJ. Pilot study of a web-delivered multicomponent intervention for rural teens with poorly controlled type 1 diabetes. Journal of Diabetes Research. 2016;2016:7485613. https://doi.org/10.1155/2016/7485613 
  33. Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: systematic review and meta-analyses. PLoS Medicine. 2020;17(3):e1003053. https://doi.org/10.1371/journal.pmed.1003053