The development and evaluation of a web-based diet and diabetes education programme for children with type 1 diabetes

Abstract

Diabetes education is one of the essential components of standard diabetes care. Rapid advances in technology have made the internet a viable mode for the delivery of educational interventions to young people with type 1 diabetes (T1D). The main purpose of this study was to develop a web-based education programme to assist in diabetes management and to provide support for children with T1D in Malaysia. The data were collected in three phases using a mix method approach. Participants were children with T1D living in Malaysia (n=64), their parents (n=12), the clinicians (n=3) and Malaysian‟ children living in Newcastle (n=12). In Phase one, the data were collected using both qualitative and quantitative methods to understand the experiences and challenges which children face living with diabetes and to identify regularly consumed carbohydrate-rich foods. In Phase two, data were gathered by a semi-structured interview and an open-ended questionnaire with healthy children in Newcastle to elicit views and general usability of the programme. In the final Phase, Phase three, children with T1D and their families were recruited and introduced to the programme and guided in its use at home. Semi-structured interviews were conducted with children, parents and clinicians, and the questionnaires were used with children in order to gain participants‟ views, experiences and acceptance of the system. Children used the programme for a period of six months. Most children reported using the programme to obtain information about carbohydrate content of the food and drink they consumed and adjusting their insulin accordingly. They also reported they had made changes in their food choices based on the information and knowledge they obtained from the programme. Most of them did not record their blood glucose regularly in the programme. The majority felt confident in managing their diet, insulin, and monitoring their blood glucose, however, a few reported lack of confidence and difficulty managing their diabetes. Clinicians indicated that the programme was feasible to use in the clinic setting to teach and review children‟ blood glucose and dietary intake, and to support children when they faced any problems related to their diabetes. The clinicians believed that the programme had the most application for children as a self-education and self-management system. Overall, participants described the programme as useful, accessible and beneficial for managing diet and diabetes. This study demonstrated feasibility of using the web-based education programme. Further research is required to determine the effectiveness of the programme in improving diabetes management of T1D by young people.