16-OR: Codesigning an Intervention for Adults with New-Onset Type 1 Diabetes to Improve Psychological and Social Adaptation

Abstract

Adults newly diagnosed with type 1 diabetes (T1D) can experience significant psychosocial disruption, leading to maladaptive emotional and behavioral responses which may increase the risk of future complications. The aim of the study was to co-design an intervention with people with diabetes (PWD) and healthcare-professionals (HCPs) to address the psychosocial disruption associated with new onset T1D in adults. We used a co-design approach to stimulate the target populations to reflect on their experiences and generate ideas for the intervention. This involved the use of illustrations depicting common experiences of the time of diagnosis identified in a previous study among PWD and HCPs. Illustrations were used as conversation tools in six parallel workshops exclusively for PWD (n=24) and HCPs (n=55); and four workshops that brought PWD (n=31) and HCPs (n=19) together to prioritize intervention components. Data comprising of transcribed audio recordings and notes from participants were analyzed thematically with a view to intervention development. The workshops identified that the intervention should be phasic, with an initial focus on the psychosocial disruption of diagnosis, followed by the early experience of diabetes and how to adapt positively to a life with it. Participants constructed two integrated intervention components: 1) one-to-one sessions soon after diagnosis, with a HCP trained in using a psychologically modelled conversation tool addressing PWD’s experiences, thoughts and feelings about the diagnosis; and 2) a group-based intervention addressing common diabetes challenges, emotional issues and thinking traps, focusing on normalizing emotions and developing strategies for managing diabetes in day-to-day life. The co-design process revealed the benefit of adopting a bio-psycho-social perspective and introducing methods of support involving both HCPs and peers to activate positive adaptive strategies in adults with new onset T1D. Disclosure M. Due-Christensen: Research Support; Self; Novo Nordisk Foundation. Stock/Shareholder; Self; Novo Nordisk A/S. L.E. Joensen: None. S. Sarre: None. J.L. Wad: None. E. Romanczuk: None. R. Forde: None. I. Willaing: None. A. Forbes: None. Funding National Institute for Health Research (PB-PG-0317-20012); Novo Nordisk Foundation (NNF17OC0028274)