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Identifying Potential Sustainable and Scalable Interventions to Recognize Signs of Diabetes in Children Across Canada
Zeenat Ladak1, Priscilla Medeiros2, Geneviève Rouleau3
1Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada; Women's College Hospital Institute for Health System Solutions & Virtual Care, Women's College Hospital, Toronto, Ontario, Canada.
Insights
Early recognition of childhood diabetes signs can prevent dangerous diabetic ketoacidosis. This study explored strategies for a Canadian intervention to improve diagnosis and awareness of diabetes symptoms in children.
Area of Science:
- Pediatric Endocrinology
- Public Health Interventions
- Qualitative Research Methods
Background:
- Delayed diagnosis of diabetes in children frequently leads to diabetic ketoacidosis, a serious complication.
- Diabetic ketoacidosis is preventable through prompt recognition of symptoms, timely medical attention, and swift diagnosis and management.
- Developing effective interventions is crucial to mitigate the risks associated with delayed diagnosis in pediatric diabetes.
Purpose of the Study:
- To plan the development of an evidence and theory-informed intervention.
- To recognize the signs of diabetes in children and prevent diabetic ketoacidosis.
- To ensure potential for widespread implementation and long-term impact across Canada.
Main Methods:
- Qualitative exploratory study involving 41 participants, including researchers, educators, parents, caregivers, and health organization representatives.
- Focus groups and interviews were conducted to explore opportunities for adapting, sustaining, scaling, and evaluating diabetes awareness interventions.
- Content analysis of transcripts was used to identify barriers and facilitators for potential interventions.
Main Results:
- Participants suggested interventions like posters, magnets, educational cards, and mass media campaigns to raise awareness of childhood diabetes signs.
- Strategies like refrigerator magnets offer long-term visibility, while mass media requires significant resources.
- Challenges were identified in intervention evaluation and tailoring strategies for diverse Canadian populations.
Conclusions:
- This research provides foundational insights for developing, implementing, and evaluating a national Canadian strategy.
- The strategy aims to improve the recognition of diabetes signs in children.
- The ultimate goal is to prevent delayed diagnoses and associated complications like diabetic ketoacidosis.
Objectives:
Delayed diagnosis of diabetes in children can lead to diabetic ketoacidosis, a life-threatening condition occurring in 10% to 80% of children at diabetes diagnosis. Ketoacidosis is preventable with prompt recognition of signs, urgent attendance to care, and rapid diagnosis and management. Our aim in this study was to plan for the development of an intervention to recognize signs of diabetes in children and prevent ketoacidosis that is evidence and theory informed and has potential for widespread implementation and long-term impact across Canada.
Methods:
This qualitative exploratory study included researchers, educators, parents, caregivers, and representatives from relevant health-care organizations (n=41). Through targeted recruitment and snowball sampling, participants took part in a focus group or interview on opportunities to adapt, sustain, scale, and evaluate various diabetes awareness interventions. Transcripts were analyzed using content analysis to examine barriers and facilitators of potential interventions.
Results:
Participants proposed several interventions, including using posters, magnets, educational take-home cards, and mass media, to increase awareness about the signs of diabetes in children and the need to rapidly seek care to prevent delayed diagnosis. Each strategy was noted to have advantages, such as refrigerator magnets being visible for a long time, and disadvantages, such as high-cost resources required for mass media. Participants also identified challenges in evaluating interventions and about how to tailor strategies for specific populations while remaining relevant across Canada.
Conclusions:
This work informs the development, implementation, and evaluation of a Canadian strategy to recognize signs of diabetes in children and prevent a delay in diagnosis.
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