Type 1 Diabetes Clinical Trial
Official title:
Effectiveness of a Person-Centred Transition Program to Empower Adolescents With Type 1 Diabetes in the Transition to Adulthood: the STEPSTONES-DIAB Project
The transfer of young people with type 1 diabetes (T1D) to adult care occurs during a critical period of life, while many young people with T1D have unsatisfactory glycemic control. The preparation to take over responsibility for their health and self-care as well as increasing their participation in care are important aspects for strengthening people's own ability, an important component of person-centered care. STEPSTONES-DIAB aims to evaluate the effectiveness of a person-centred transition program for adolescents with T1D to empower them to become active partners in their care. The study is conducted at two hospitals in Stockholm, Sweden where 140 patients will be randomized to either a structured, person-centered transition program over a 2.5 -year period or to usual care. Outcome measures is empowerment, participation and responsibility in care, health status, glycemic control as well as the participants' experiences of care during transfer.
Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood. Each year,
nearly 86 000 children around the world develop T1D. The annual mean incidence rates varies
from 0.1-60/100000 with Sweden as one of the "top" incidence countries. Within diabetes care,
most health care professionals agree that a lack of effective transfer from pediatric to
adult care may contribute to insufficient continuity of health care and increased risk for
adverse outcomes in young adults with T1D diabetes. In order to help the adolescent in the
transitions to adulthood and adult care, transitions programs have been proposed as a complex
intervention with the objective of maximizing lifelong functioning and potential through
appropriate healthcare services. Therefore, research on transition and transfer, and on
interventions that have the potential to improve both these clinical processes, is important.
Patient empowerment is recognized as an essential element of transition interventions.
Through the promotion of patient empowerment the adolescents can become active partners in
their care and have the knowledge and capacity to make decisions that affect their life and
health status. The purpose of this study is to assess the effectiveness of a transition
program for adolescents with type 1 diabetes within a randomized controlled trial. During the
course of the study, participants will be part of a transition program or receive usual care
before being transferred to adult care. The primary outcome is level of empowerment and
secondary outcomes include health behavior as well as diabetes specific and transfer specific
variables.
The investigators will assess the effectiveness of the transition program by comparing the
level of empowerment (primary outcome) between the participants who received usual care and
those who participated in the transition program. A higher level of empowerment from the
group part of the intervention is expected. The economic evaluation entails an impact budget
assessment and a cost-effectiveness analysis.
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