Department of Diabetes and Endocrinology, Guy's and St.Thomas 'NHS foundation Trust, London, UK.
Health Service and Population Research Department, King's College London, London, UK
BMJ Open. 2022 Jun 9;12(6):e062971. doi: 10.1136/bmjopen-2022-062971.
Adolescence is a challenging period for young people with type 1 diabetes, associated with worsening glycaemia and care disengagement. Educational interventions in this period tend to focus on diabetes-specific skills, with less emphasis on the psychosocial challenges associated with diabetes experienced by young people. To address this limitation, we codesigned with young people a psychosocially modelled programme of diabetes education, named 'Youth Empowerment Skills' (YES). The programme aims to facilitate a positive adaptation to life with diabetes and engagement with diabetes care through peer-based learning, immersive simulations and support from an outreach youth worker. Here, we present a protocol for a feasibility study of the YES programme.
The study was designed following the Medical Research Council Complex Intervention Evaluation Framework to: test the feasibility (acceptance, implementability, recruitment and completion) of the YES programme; and estimate its efficacy in relation to metabolic and psychosocial outcomes. The study will take place in diabetes centres serving socioculturally diverse populations. We will conduct a feasibility randomised controlled trial (waiting-list design) with integrated process evaluation. Fifty young people with type 1 diabetes (aged 14-19 years) will be randomly allocated to either the YES intervention or a waiting-list control. Randomisation acceptability will be assessed with provision for a preference allocation. Outcomes will be evaluated at 6 months, at which point the waiting list participants will be exposed to the YES programme with further follow-up to 12 months. A simultaneous process evaluation will use a mixed-methods approach collecting qualitative and quantitative data. Study findings will be used to optimise the intervention components, outcome measures and recruitment methods to inform a subsequent definitive trial.
The protocol has ethical approval from the UK Health Research Authority (approval IRAS project ID: 279877). Findings will be disseminated in multiple formats for lay and professional audiences.
7 April 2021, V.1.1.
NCT04670198.
青春期对于 1 型糖尿病患者来说是一个充满挑战的时期,这一时期患者的血糖控制往往会恶化,同时也会出现对护理的抵触。在这一时期的教育干预往往侧重于糖尿病的具体技能,而对年轻人所经历的与糖尿病相关的心理社会挑战关注较少。为了解决这一局限性,我们与年轻人共同设计了一种心理社会模型的糖尿病教育项目,命名为“青年赋权技能”(Youth Empowerment Skills,YES)。该项目旨在通过同伴学习、沉浸式模拟和外展青年工作者的支持,促进年轻人积极适应糖尿病生活并参与糖尿病护理。在这里,我们提出了一项关于 YES 项目可行性研究的方案。
该研究是根据医疗研究委员会复杂干预评估框架设计的:测试 YES 项目的可行性(接受度、实施性、招募和完成);并估计其在代谢和心理社会结果方面的疗效。该研究将在为不同社会文化群体服务的糖尿病中心进行。我们将进行一项可行性随机对照试验(等待名单设计),并进行综合的过程评估。将随机分配 50 名 14-19 岁的 1 型糖尿病患者进入 YES 干预组或等待名单对照组。将通过提供偏好分配来评估随机分配的可接受性。结果将在 6 个月时进行评估,届时等待名单上的参与者将接受 YES 项目的干预,并在 12 个月时进行进一步的随访。同时进行的过程评估将采用混合方法收集定性和定量数据。研究结果将用于优化干预内容、结果测量和招募方法,以为随后的确定性试验提供信息。
该方案已获得英国健康研究管理局的伦理批准(批准的 IRAS 项目 ID:279877)。研究结果将以多种形式向非专业和专业受众传播。
2021 年 4 月 7 日,V.1.1。
NCT04670198。