Developing intervention content through qualitative research and stakeholder engagement: the D1 Now intervention

Abstract

Background: As part of intervention development, the aim of this study was to (1) engage key stakeholders and (2) explore perceptions of barriers and facilitators to self-management among young adults with Type 1 Diabetes (T1D) using the COM-B (Capability, Opportunity, Motivation – Behaviour) Model of behaviour change. Methods: A Young Adult Panel (8 service-users aged between 18-25 years living with T1D) was formed, which guided the research process and informed the development of interview topic guides. Interviews were conducted with parents of young adults with T1D (n=10) and health service providers (n=15), and focus groups (n=3) were conducted with young adults, at 3 sites (Galway, Belfast and Dublin). Thematic analysis was used to analyse the data using the framework of the COM-B model to identify and categorise the determinants of T1D self-management among young adults. Findings: Diabetes education and regular, informal access to diabetes-related information was considered vital to capability to engage in diabetes self-management. However, self-management behaviour appeared to be determined by external physical and social factors such as access to a supportive diabetes team. External factors may directly drive self-management behaviour, for example through a stable daily routine, or influence motivation, for example through beliefs about capability to engage in self-management. Resources such as diabetes devices and peer networks enhanced self-management. Young adult’s identity as a person living with T1D was an important determinant of self-management behaviour. Discussion: Interventions should target environmental factors to positively influence capability and motivation to engage in T1D self-management among young adults.