Cardiovascular Disease (CVD) Decision Aid for Youth with Type 1 Diabetes (T1DM)—Perspectives of Health Care Providers (HCPs) with Pediatric-Onset T1DM

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 698-P
Author(s):  
JODI KRALL ◽  
INGRID LIBMAN ◽  
SAMINA AFREEN ◽  
LINDA M. SIMINERIO
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Type 1 Diabetes ◽  
Health Care Providers ◽  
Decision Aid ◽  
Care Providers ◽  
Pediatric Onset

scholarly journals Development of an eHealth Program for Parents of Adolescents With Type 1 Diabetes

2017 ◽  
Vol 44 (1) ◽  
pp. 72-82 ◽  
Author(s):  
Robin Whittemore ◽  
Rebekah M. Zincavage ◽  
Sarah S. Jaser ◽  
Margaret Grey ◽  
Julia L. Coleman ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Health Care Providers ◽  
Diabetes Care ◽  
Multiple Time ◽  
Hormonal Changes ◽  
Care Providers ◽  
Personal Time ◽  
Multiple Time Points

Purpose The purpose of this study was to understand the experience of parenting an adolescent with type 1 diabetes (T1DM), to develop a prototype of an eHealth program for parents of adolescents with T1DM, and to evaluate the prototype content and acceptability from the perspective of parents and health care providers. Methods A multiphase method was used generating both qualitative and quantitative data at multiple time points. There were 27 parents of adolescents aged 12 to 18 years with T1DM and 16 health care providers who participated in semistructured interviews to identify parental challenges; 53 parents and 27 providers evaluated the prototype. Thematic content analysis was used to analyze interview transcripts, and descriptive statistics were used to summarize survey data. Results Challenges experienced by parents of adolescents with T1DM included understanding the developmental and hormonal changes of adolescence that affect diabetes care, feeling tension between adolescent independence and parent control, communicating without nagging or conflict, transferring diabetes care responsibility safely, dealing with feelings of stress and distress, and perceiving a lack of resources for T1DM care and insufficient personal time for self-care. In the prototype evaluation, both parents and providers found content to be relevant and provided feedback to guide the development of the full program. Conclusions Parents of adolescents with T1DM and providers expressed a need for parents to have more support in transitioning diabetes care from parent to adolescent. eHealth programs offer an ideal way to address these needs and ultimately can be linked to electronic medical records improving quality and efficiency of health care in this population.

Working Toward an mHealth Platform for Adolescents with Type 1 Diabetes: Focus Groups With Teens, Parents, and Providers

2020 ◽  
Vol 46 (5) ◽  
pp. 444-454
Author(s):  
Manuela Sinisterra ◽  
Katherine Patterson Kelly ◽  
Caitlin Shneider ◽  
Ashley El-Zein ◽  
Ellen Swartwout ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Focus Groups ◽  
Health Care Providers ◽  
Diabetes Management ◽  
Self Management ◽  
Care Providers ◽  
Open Communication ◽  
Management Behaviors

Purpose The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform. Methods Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors. Results Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families. Conclusion Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.

scholarly journals Substance Use Among Adolescents and Young Adults With Type 1 Diabetes: Discussions in Routine Diabetes Care

2020 ◽  
Vol 59 (4-5) ◽  
pp. 388-395
Author(s):  
Samantha P. Bento ◽  
MaryJane S. Campbell ◽  
Olivia Soutullo ◽  
Fran R. Cogen ◽  
Maureen Monaghan
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Type 1 Diabetes ◽  
Young Adults ◽  
Health Care Providers ◽  
Adolescents And Young Adults ◽  
Care Providers ◽  
Diabetes Clinic ◽  
Pediatric Health Care

Pediatric health care providers are in a unique position to discuss the health implications of alcohol, tobacco, and drug use with adolescents and young adults (AYAs) with type 1 diabetes (T1D). This study evaluated the frequency of self-reported substance use and associated demographic and clinical characteristics in a sample of AYAs with T1D and patient-provider discussions of substance use in T1D care. Sixty-four AYAs completed questions about substance use from the Youth Risk Behavior Survey (YRBS). Corresponding diabetes clinic visits were audio-recorded, transcribed, and reviewed to examine substance use discussions. A total of 56.3% of AYAs reported ever engaging in substance use; 40.6% reported substance use within the past 30 days. Five AYAs had discussions about substance use during their most recent diabetes clinic visit. Substance use should be proactively addressed by pediatric health care providers and AYAs should be encouraged to raise questions related to substance use during clinic visits.

scholarly journals Communication matters: The role of autonomy-supportive communication by health care providers and parents in adolescents with type 1 diabetes

2020 ◽  
Vol 163 ◽  
pp. 108153 ◽  
Author(s):  
Eveline R. Goethals ◽  
Sarah S. Jaser ◽  
Chris Verhaak ◽  
Sofie Prikken ◽  
Kristina Casteels ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Health Care Providers ◽  
Care Providers ◽  
Supportive Communication

scholarly journals Shared Decision-Making Among Caregivers and Health Care Providers of Youth with Type 1 Diabetes

2014 ◽  
Vol 21 (3) ◽  
pp. 234-243 ◽  
Author(s):  
Jessica M. Valenzuela ◽  
Laura B. Smith ◽  
Jeanette M. Stafford ◽  
Ralph B. D’Agostino ◽  
Jean M. Lawrence ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Type 1 Diabetes ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Shared Decision ◽  
Care Providers

scholarly journals A Web-Based Coping Intervention by and for Parents of Very Young Children With Type 1 Diabetes: User-Centered Design (Preprint)

2018 ◽  
Author(s):  
Tim Wysocki ◽  
Jessica Pierce ◽  
Cindy Caldwell ◽  
Karen Aroian ◽  
Louis Miller ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Young Children ◽  
Health Care Providers ◽  
User Centered Design ◽  
Care Providers ◽  
Coping Resource ◽  
Web Based ◽  
Very Young Children

BACKGROUND Management of type 1 diabetes (T1D) among children aged <6 years is exceptionally challenging for parents and caregivers. Metabolic and psychosocial outcomes among very young children with T1D (YC-T1D) are tightly associated with their parents’ ability to meet these challenges. There is scant research testing interventions targeting these issues and few resources to equip health care providers with feasible and effective coping strategies for these parents. User-centered design (UCD) of a continuously accessible Web-based resource could be a mechanism for helping parents of YC-T1D cope more effectively with the complex challenges they face by providing them with information, solutions, and emotional support. OBJECTIVE The objectives of this paper are to (1) describe the application of UCD principles to the development of a Web-based coping intervention designed by and for parents of very young children (<6 years old) with T1D; (2) illustrate the use of crowdsourcing methods in obtaining the perspectives of parents, health care providers, and Web development professionals in designing and creating this resource; and (3) summarize the design of an ongoing randomized controlled trial (RCT) that is evaluating the effects of parental access to this resource on pertinent child and parent outcomes. METHODS This paper illustrates the application of UCD principles to create a Web-based coping resource designed by and for parents of YC-T1D. A Web-based Parent Crowd, a Health Care Provider Crowd, and a Focus Group of minority parents provided input throughout the design process. A formal usability testing session and design webinars yielded additional stakeholder input to further refine the end product. RESULTS This paper describes the completed website and the ongoing RCT to evaluate the effects of using this Web-based resource on pertinent parent and child outcomes. CONCLUSIONS UCD principles and the targeted application of crowdsourcing methods provided the foundation for the development, construction, and evaluation of a continuously accessible, archived, user-responsive coping resource designed by and for parents of YC-T1D. The process described here could be a template for the development of similar resources for other special populations that are enduring specific medical or psychosocial distress. The ongoing RCT is the final step in the UCD process and is designed to validate its merits.

scholarly journals Teleassistance for Patients With Type 1 Diabetes During the COVID-19 Pandemic: Results of a Pilot Study (Preprint)

2020 ◽  
Author(s):  
Martina Parise ◽  
Linda Tartaglione ◽  
Antonio Cutruzzolà ◽  
Maria Ida Maiorino ◽  
Katherine Esposito ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Disease Management ◽  
Health Care Providers ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Care Providers ◽  
Virtual Visits

BACKGROUND Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers. OBJECTIVE During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period. METHODS This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit. RESULTS Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; <i>P</i>&lt;.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (<i>P</i>=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; <i>P</i>=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; <i>P</i>&lt;.001) than in those with a GMI of &lt;7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; <i>P</i>=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (<i>P</i>=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters. CONCLUSIONS These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.

scholarly journals Assessing utility of a lifestyle-based tool in the clinical setting as a primordial prevention strategy: The Healthy Heart Score

2020 ◽  
pp. 174239531989943
Author(s):  
Samantha Buls ◽  
Elizabeth A Beverly ◽  
Darlene E Berryman ◽  
Mercedes Sotos-Prieto
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Health Care Providers ◽  
Clinical Setting ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Impact Behavior ◽  
Care Providers ◽  
Primordial Prevention ◽  
Heart Score

Objective To evaluate the opinions of primary health-care providers and patients regarding the use of the Healthy Heart Score 20-year cardiovascular disease risk assessment tool in the clinical setting. Methods Semi-structured in person or phone interviews among 20 patients with no self-reported cardiovascular disease diagnoses and 20 health-care providers in Central (Columbus) and Southeastern (Athens) regions of Ohio. The researchers independently coded transcribed interviews, discussed codes to resolve discrepancies, and agreed on common themes. Results Participants suggested ways to best utilize and improve the tool, including adding graphics for visual reference of serving size. Patients showed interest in cardiovascular disease primordial prevention and expressed willingness to take the assessment prior to seeing a health-care provider. Health-care providers said that they would recommend the assessment to their patients and would be willing to use the tool in their practice. Health-care providers stated few barriers to using the tool, yet discussed numerous challenges to successful primordial prevention. Conclusions Our findings support the utilization of the Healthy Heart Score as a cardiovascular disease primordial prevention tool in the clinical setting. Additional research implementing the tool into the clinical setting will provide deeper insight into how the tool can impact behavior change and cardiovascular disease prevention.

A Canadian Cross-Sectional Survey on Psychosocial Supports for Adults Living With Type 1 or 2 Diabetes: Health-Care Providers' Awareness, Capacity and Motivation

2018 ◽  
Vol 42 (4) ◽  
pp. 389-394.e2 ◽  
Author(s):  
Jennica Nichols ◽  
Michael Vallis ◽  
Stephanie Boutette ◽  
Carolyn Gall Casey ◽  
Catherine H. Yu
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Update on the Management of Diabetes during Ramadan Fast for Healthcare Practitioners

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
Rathor MY ◽  
Mohammad Fauzi AR ◽  
Omar AM
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Chronic Illnesses ◽  
Current Evidence ◽  
Care Providers ◽  
Ramadan Fasting ◽  
Expert Opinions ◽  
The World

Fasting during the month of Ramadan is one of the five pillars of Islam, a recurring annual ritual, which is passionately practiced by most Muslims across the world. It is obligatory on every healthy Muslim; however, the Qur’an and Islamic teachings specifically exempt people with acute or chronic illnesses from this duty, especially if it might have harmful consequences. Muslims with diabetes are exempted from fasting, but many of them still fast during Ramadan, for their personal convictions as revealed by EPIDIAR study which showed that 43% of patients with type 1 diabetes and 79% with type 2 diabetes fasted during Ramadan. Muslims constitute about a quarter of the world’s population who are spread all over the globe. It is inevitable that health care issues peculiar to them will be encountered worldwide and health care providers will have to counsel them regarding medications and whether it is safe to undertake the fast. This paper is an update on the management of Ramadan fasting based on current evidence from published literature and expert opinions.

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