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理解大型 1 型糖尿病行为试验中青少年和家长的可接受性和可行性经验。

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

机构信息

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.

Divisions of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

出版信息

Diabet Med. 2020 Jul;37(7):1134-1145. doi: 10.1111/dme.13913. Epub 2019 Feb 12.

Abstract

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.

摘要

目的

本研究以一项为期 18 个月的多中心随机对照试验为例,旨在确定与青少年和家长参与旨在改善青少年 1 型糖尿病自我管理的大型行为试验相关的可行性和可接受性主题。

方法

采用专题分析方法来制定描述可接受性和可行性相关因素的主题。

结果

基于访谈样本(N=72),确定了与干预可接受性和可行性相关的因素。可接受性的方面包括:目标设定框架、教练作为非评判性的倾听者、对持续参与的益处的感知以及交付模式。可行性方面包括:参与者的利他主义精神,以帮助 1 型糖尿病青少年;对干预内容和持续时间的预注册准备;以及通过电话或视频进行远程干预的选择,最大限度地减少旅行时间和费用。此外,参与者描述了积极的结果,包括行为、1 型糖尿病自我管理行为和家长-青少年沟通的改善,以及情绪态度的变化。参与者还描述了可能会为未来的试验提供信息的潜在修订。

结论

慢性病青少年行为干预的可接受性和可行性具有多因素的维度。在增强青少年自我管理能力的同时,对父母的支持也是一个被低估的方面。为后续的行为试验确定了潜在的修订。

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