Garner Katie, Thabrew Hiran, Lim David, Hofman Paul, Jefferies Craig, Serlachius Anna
Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand.
Liggins Institute and Department of Pediatrics, University of Auckland, Auckland, New Zealand.
JMIR Pediatr Parent. 2023 Dec 22;6:e52364. doi: 10.2196/52364.
Adolescents living with either type 1 diabetes (T1D) or type 2 diabetes (T2D) have an increased risk of psychological disorders due to the demands of managing a chronic illness and the challenges of adolescence. Psychological disorders during adolescence increase the risk of suboptimal glycemic outcomes and may lead to serious diabetes-related complications. Research shows that digital health interventions may increase access to psychological support for adolescents and improve physical and mental health outcomes for youth with diabetes. To our knowledge, there are no evidence-based, publicly available mental health apps with a focus on improving the psychological well-being of adolescents with diabetes.
This study aimed to explore the acceptability and usability of our evidence-based well-being app for New Zealand adolescents, Whitu: 7 Ways in 7 Days (Whitu), to allow us to further tailor it for youth with diabetes. We interviewed adolescents with T1D and T2D, their parents, and health care professionals to explore their views on the Whitu app and suggestions for tailoring the app for adolescent with diabetes. We also explored the cultural acceptability of the Whitu app for Māori and Pacific adolescents.
A total of 34 participants, comprising 13 adolescents aged 12-16 years (11 with T1D and 2 with T2D), 10 parents, and 11 health care professionals, were recruited from a specialist diabetes outpatient clinic and Facebook diabetes groups. Each participant attended one 1-hour focus group on Zoom, in person, or via phone. Researchers gathered general feedback on what makes an effective and engaging app for adolescents with diabetes, as well as specific feedback about Whitu. Transcribed audio recordings of the focus groups were analyzed using directed content analysis.
Adolescents with T1D, their parents, and health care professionals found Whitu to be acceptable and usable. Adolescents with T1D and their parents signaled a preference for more diabetes-specific content. Health care professionals expressed less awareness and trust of digital health interventions and, as such, recommended that they be used with external support. Due to challenges in recruitment and retention, we were unable to include the views of adolescents with T2D in this qualitative study.
There appears to be sufficient openness to the use of an app such as Whitu for supporting the well-being of adolescents with T1D, albeit with modifications to make its content more diabetes specific. Based on this qualitative study, we have recently developed a diabetes-specific version of Whitu (called LIFT: Thriving with Diabetes). We are also planning a qualitative study to explore the views of youth with T2D and their perspectives on the new LIFT app, where we are using alternative research approaches to recruit and engage adolescents with T2D and their families.
患有1型糖尿病（T1D）或2型糖尿病（T2D）的青少年，由于需要管理慢性病以及面临青春期的挑战，患心理障碍的风险增加。青春期的心理障碍会增加血糖控制不佳的风险，并可能导致严重的糖尿病相关并发症。研究表明，数字健康干预措施可能会增加青少年获得心理支持的机会，并改善糖尿病青少年的身心健康状况。据我们所知，目前还没有以改善糖尿病青少年心理健康为重点的循证、公开可用的心理健康应用程序。
本研究旨在探讨我们基于循证的幸福应用程序“Whitu：七天七种方式”（Whitu）对新西兰青少年的可接受性和可用性，以便我们能进一步为糖尿病青少年量身定制。我们采访了患有T1D和T2D的青少年、他们的父母以及医疗保健专业人员，以了解他们对Whitu应用程序的看法，以及为糖尿病青少年量身定制该应用程序的建议。我们还探讨了Whitu应用程序对毛利族和太平洋岛裔青少年的文化可接受性。
从一家专科糖尿病门诊诊所和脸书糖尿病群组中招募了34名参与者，包括13名12至16岁的青少年（11名患有T1D，2名患有T2D）、10名家长和11名医疗保健专业人员。每位参与者通过Zoom、亲自或电话参加了一个1小时的焦点小组。研究人员收集了关于如何制作一款对糖尿病青少年有效且有吸引力的应用程序的总体反馈，以及关于Whitu的具体反馈。使用定向内容分析法对焦点小组的转录音频记录进行了分析。
患有T1D 的青少年、他们的父母以及医疗保健专业人员认为Whitu是可接受且可用的。患有T1D的青少年及其父母表示更喜欢更多针对糖尿病的内容。医疗保健专业人员对数字健康干预措施的了解和信任较少，因此建议在外部支持下使用这些措施。由于招募和留住参与者存在挑战，我们无法将患有T2D的青少年的观点纳入本定性研究。
对于使用Whitu这样的应用程序来支持患有T1D的青少年的幸福似乎有足够的开放性，尽管需要进行修改以使内容更具糖尿病针对性。基于这项定性研究，我们最近开发了一个针对糖尿病的Whitu版本（称为LIFT：与糖尿病共成长）。我们还计划进行一项定性研究，以探讨患有T2D的青少年的观点以及他们对新的LIFT应用程序的看法，我们将使用替代研究方法来招募和吸引患有T2D的青少年及其家庭参与。
