Testing a theory of clinic attendance behaviour among young adults with type 1 diabetes

Abstract

Background Clinic non-attendance is common among young adults with type 1 diabetes, a group at risk of diabetes-related and psychosocial problems. An in-depth understanding of the factors contributing to clinic attendance was needed to inform intervention development. The aim of this study was to test a theory of clinic attendance, developed in previous studies, in an international sample of young adults with type 1 diabetes. Methods Young adults (n = 154), with type 1 diabetes and aged between 18 and 30 years, completed a questionnaire which was compiled based on the theory of clinic attendance. Structural Equation Modelling and moderation analyses were used to analyse the data. Results In line with the theory of clinic attendance, good relationships between young adults and service providers predicted higher levels of engagement, informal contact with the diabetes clinic (e.g. by telephone), and attendance rates among young adults. Gender and treatment modality were the only additional variables which explained clinic attendance behaviour. Satisfaction with the clinic was important in relation to clinic attendance among young adults who were less engaged but only predicted clinic attendance among young adults who had a good relationship with service providers. Conclusion Interventions to improve clinic attendance behaviour should prioritise the development of relationships between young adults and service providers. Addressing issues related to relationship development will benefit young adults and service providers. Future intervention research based on our theory of clinic attendance will provide further insights into the role of the diabetes clinic in supporting young adults’ self-management.