Farrington Conor, Allen Janet, Tauschmann Martin, Randell Tabitha, Trevelyan Nicola, Hovorka Roman
1 Cambridge Centre for Health Services Research, Institute of Public Health, School of Clinical Medicine, University of Cambridge , Cambridge, United Kingdom .
2 Department of Paediatrics, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge , Cambridge, United Kingdom .
Diabetes Technol Ther. 2016 Sep;18(9):568-73. doi: 10.1089/dia.2016.0157. Epub 2016 Jun 29.
Relatively little is known about parents' or children's attitudes toward recruitment for, and participation in, studies of new diabetes technologies immediately after diagnosis. This study investigated factors affecting recruitment of participants for studies in newly diagnosed youth with type 1 diabetes.
Qualitative focus group study incorporating four recorded focus groups, conducted in four outpatient pediatric diabetes clinics in large regional hospitals in England. Participants comprised four groups of parents (n = 22) and youth (n = 17) with type 1 diabetes, purposively sampled on the basis of past involvement (either participation or nonparticipation) in an ongoing two-arm randomized trial comparing multiple daily injection with conventional continuous subcutaneous insulin infusion regimens from the onset of type 1 diabetes.
Stress associated with diagnosis presents significant challenges in terms of study recruitment, with parents demonstrating varied levels of willingness to be approached soon after diagnosis. Additional challenges arise regarding the following: randomization when study arms are perceived as sharply differentiated in terms of therapy effectiveness; burdens arising from study participation; and the need to surrender new technologies following the end of the study. However, these challenges were mostly insufficient to rule out study participation. Participants emphasized the benefits and reassurance arising from support provided by staff and fellow study participants.
Recruitment to studies of new diabetes technologies immediately after diagnosis in youth presents significant challenges, but these are not insurmountable. The stress and uncertainty arising from potential participation may be alleviated by personalized discussion with staff and peer support from fellow study participants.
对于糖尿病确诊后,父母或孩子对新型糖尿病技术研究招募及参与的态度,我们了解得相对较少。本研究调查了影响新诊断的1型糖尿病青少年参与研究招募的因素。
采用定性焦点小组研究,在英格兰大型地区医院的四家门诊儿科糖尿病诊所进行了四次录音焦点小组讨论。参与者包括四组患有1型糖尿病的父母(n = 22)和青少年(n = 17),根据过去在一项正在进行的双臂随机试验中的参与情况(参与或未参与)进行目的性抽样,该试验比较了1型糖尿病发病时每日多次注射与传统持续皮下胰岛素输注方案。
与诊断相关的压力在研究招募方面带来了重大挑战,父母在诊断后不久被联系时表现出不同程度的意愿。在以下方面还出现了其他挑战:当研究组在治疗效果方面被认为有明显差异时的随机分组;研究参与带来的负担;以及研究结束后放弃新技术的必要性。然而,这些挑战大多不足以排除参与研究。参与者强调了工作人员和其他研究参与者提供的支持所带来的益处和安心感。
在青少年糖尿病确诊后立即招募参与新型糖尿病技术研究面临重大挑战,但并非无法克服。通过与工作人员进行个性化讨论以及获得其他研究参与者的同伴支持,可能会减轻潜在参与带来的压力和不确定性。