December 2017 NUI Galway ‘D1 Now’ Programme to Improve Services for Young Adults with Type 1 Diabetes

A diabetes research team at NUI Galway’s School of Medicine has developed a novel approach to improve how diabetes services are delivered to young adults. The team has published two new open access articles detailing the formation of their ‘Young Adult Panel’, comprising of nine young adults aged 18–25 years with type 1 diabetes. This young group have helped design the ‘D1 Now’ intervention programme, which aims to improve diabetes services by reimagining care and moving beyond the traditional clinic.

Research indicates that this particular age group of young adults with type 1 diabetes often disengage from health services and their general diabetes management. Involving young adults with this condition in co-designing research to help develop a behaviour change in intervention to improve engagement with health services could potentially improve overall self-management and health.

Many young adults with type 1 diabetes find it hard to control their blood glucose levels. With lots going on in their lives, their diabetes is often not the priority and means they do not always take care of their condition such as attending clinic appointments. These young adults do not usually get the chance to make suggestions on how to improve diabetes services. Being involved could help shape the diabetes care services that support them.

The D1 Now research team at NUI Galway, led by Professor Seán Dinneen, says: “Through the formation of the D1 Now Young Adult Panel, it demonstrates that involving young adults with this condition in health service research, is feasible and productive. Their guidance and feedback is instrumental in creating an intervention with a difference. It also demonstrates that involving young adults in co-designing research to develop a complex behaviour change intervention to improve diabetes services ensures the process is grounded in the needs and experiences of those directly affected by type 1 diabetes.”

By ensuring that young adults are at the centre of the design means that the intervention will be more acceptable to this group. Previous work from the D1 Now team indicates that young adults want care to be centred on the relationships built within their diabetes team. These new ways of engagement can offer more continuity during a time of transition, whether it takes the form of a designated staff member, through devices/eHealth tools, or through tools to facilitate shared decision-making and goal-setting.

Michelle Long, a member of the Young Adult Panel said that she was: “Proud to be part of this research paper as one of the young adults on the panel aiming to improve care for diabetes in Ireland.”

The Young Adult Panel developed research materials such as participant information sheets. They also reviewed and interpreted research findings to create plain language statements so that the team’s work is framed in the most appropriate way for young adults and anyone who may wish to engage with the research. The Panel has also helped develop the study website to enhance engagement between young adults and their diabetes healthcare providers.

The D1 Now team contributed to an international consensus conference on health services delivery for young adults with type 1 diabetes and wrote specific sections of a further grant application to test out the new intervention. As a direct result of the Young Adult Panel, a meaningful dialogue has opened up between healthcare providers and young adults within the research team.

Their involvement has led to a better understanding of what needs to be achieved in order to improve health service delivery in terms of responding to the specific needs of young adults at this transitional time in their lives. The panel have been active members in co-designing a health behaviour change intervention to improve engagement between young adults with type 1 diabetes and healthcare providers that will be evaluated in future research.

The D1 Now research team and the formation of the Young Adult Panel article won the HSE Open Access Awards last Friday, 8 December. The winner of the award was Mary Clare O’Hara from the D1Now team.

The study was funded through a Health Research Board, Definitive Interventions and Feasibility Awards grant.

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