Development and Theoretical Underpinnings of the PRIORITY Intervention: A Parenting Intervention to Prevent Disordered Eating in Children and Young People With Type 1 Diabetes.

Nicola R O’Donnell,Lucy S Hale,Christina J Jones,Rose Stewart,Debbie Cooke,Rose-Marie Satherley,Mary John

doi:10.3389/fcdhc.2022.822233

Abstract

Children and young people (CYP) with type 1 diabetes (T1D) are twice as likely to develop disordered eating (T1DE) and clinical eating disorders than those without. This has significant implications for physical and mental health, with some eating disorders associated with repeated diabetic ketoacidosis and higher HbA1c levels, both of which are life threatening. There is currently limited psychological support for CYP and families with T1D but increasingly, policy and practice are suggesting disordered eating in T1D may be effectively prevented through psychological intervention. We describe the development and theoretical underpinnings of a preventative psychological intervention for parents of CYP aged 11-14, with T1D. The intervention was informed by psychological theory, notably the Information Motivation Behaviour Skills model and Behaviour Change Technique Taxonomy. The intervention was co-developed with an expert advisory group of clinicians, and families with T1D. The manualised intervention includes two online group workshops, and supplementary online materials. The intervention continues to evolve, and feasibility findings will inform how best to align the intervention with routine care in NHS diabetes teams. Early detection and intervention are crucial in preventing T1DE, and it is hoped that the current intervention can contribute to improving the psychological and physical wellbeing of young people and families managing T1D.

Highlights

Effective management of type one diabetes (T1D) places high treatment demands on the individual [1]
Psychoeducational programmes can be an asset to diabetes clinical care as they require minimal effort and staffing to deliver and introduce topics that can be explored in more detail during clinical practice [53,54,55]
The PRIORITY intervention has been designed to be delivered as a low-intensity, manualised psychological intervention

Summary

BACKGROUND

Effective management of type one diabetes (T1D) places high treatment demands on the individual [1]. The current intervention targeted information, motivation, and behavioural skills, whilst building effective communication around T1D at the level of the child, family, and health provider This aimed to lead to improvements in parental awareness of disordered eating and adolescent development, confidence to support their child’s transition to independent food choices, skills to promote healthy body image, and positive interactions around T1D management, and prevent the development of disordered eating. It was important to the advisory group to include CYP without clinically significant eating disorders, as they felt that this is where interventions are often offered, overlooking individuals until they reach T1DE crisis point This was reflected by families and clinicians who expressed concern about the limited availability of psychological support in diabetes services. The co-development of the project has allowed us to establish several recommendations for the development of preventative interventions for T1DE

SUMMARY AND IMPLICATIONS FOR PRACTICE

DATA AVAILABILITY STATEMENT