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School-Partnered Collaborative Care (SPACE) for Pediatric Type 1 Diabetes: Development and Usability Study of a

Christine A March^1,2,3, Elissa Naame^1,2, Ingrid Libman^1,2,3

¹Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States.

|March 26, 2025

Summary

Developing a virtual school-partnered collaborative care (SPACE) model for type 1 diabetes improved intervention design. Co-creation methods ensured usability, addressing key barriers for better implementation in schools.

Keywords:

children collaborative care model diabetes management support health system partners implementation research multisystem community partners pediatric psychosocial interventions qualitative assessments quantitative assessments school health type 1 diabetes usability testing user-centered design virtual intervention youth

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Area of Science:

Implementation Science
User-Centered Design
Digital Health Interventions

Background:

School-partnered interventions show promise for improving pediatric type 1 diabetes outcomes.
Limited evidence exists on the effectiveness and sustainability of such interventions.
Intervention usability and implementation can be hindered by family, school, or health system factors.

Purpose of the Study:

To adapt an evidence-based psychosocial intervention into a virtual school-partnered collaborative care (SPACE) model for type 1 diabetes.
To identify and address potential implementation barriers through user-centered design and implementation science methods.

Main Methods:

Co-created the SPACE model with diverse stakeholders (patients, families, schools, health systems) using iterative, web-based design sessions.
Employed user-centered design techniques including idea generation, voting, and critique.
Evaluated prototype usability with school nurses via cognitive walkthroughs and the Intervention Usability Scale (IUS).

Main Results:

Generated over 90 ideas, prioritizing adaptability, communication, and outcome tracking for the SPACE model.
Identified 16 usability issues, with virtual platform access and data sharing as high-priority concerns.
IUS scores indicated appropriate usability, with no significant differences based on nurse experience or caseload.

Conclusions:

Perceived usability is a critical factor for the successful implementation of complex cross-sector interventions.
Web-based co-creation with community partners facilitated high-quality intervention design aligned with end-user needs.
Quantitative and qualitative findings support the usability of the SPACE model for pilot testing.