Group Education Program Research Articles

A prospective mixed‐methods pilot study of a novel group structured education programme for adults with cystic fibrosis diabetes

AbstractBackground: Cystic fibrosis diabetes (CFD) is associated with increased morbidity and mortality in adults with cystic fibrosis (CF). In addition, poor glycaemic control can result in microvascular complications. Group educational programmes for people with type 1 and 2 diabetes have been shown to improve diabetes outcomes. The national guidelines recommend that people with CFD should receive education regarding diabetes; however, specific CFD group education programmes have not been evaluated.Aims: This study aimed to test whether this novel diabetes contents and intervention for CFD based on the Beta Cell Education Resources for Training in Insulin and Eating (BERTIE) type 1 diabetes education programme was beneficial for adults with CFD. The adapted course, Improved Diabetes Education in Adults with Cystic Fibrosis (IDEA‐CF ), incorporated CFD‐specific topics and was delivered virtually via videoconference group sessions to facilitate peer learning and support without the risk of cross‐infection. A pilot study was conducted utilising this novel IDEA‐CF virtual structured program to ensure that the intervention met the patients’ educational needs.Methods: This randomised controlled multimethods pilot study recruited adults with CFD taking insulin therapy and cared for by a large regional CF centre. After providing written informed consent, the participants completed all the study forms and questionnaires before randomisation. Randomisation was performed using a computerised randomisation system that allocated adults with CFD into the intervention group (IDEA‐CF) or routine care group for the 12‐week study period. Participants who were randomised into the routine group continued to receive one‐on‐one education as before. Using the CF quality‐of‐life (QoL) questionnaire (revised Cystic Fibrosis Questionnaire [CFQ‐R]), outcomes were measured at baseline and 12‐week visits in both groups. The participants in the intervention group were asked to take part in a semistructured qualitative interview after the completion of the intervention, which was performed by a CF psychologist.Results: A total of 20 participants were recruited, with 18 completing the intervention and study follow‐up visits. In the CFQ‐R domains, physical functioning, emotional functioning, eating, role functioning and respiratory symptoms were significantly improved in the intervention group compared with the routine care group. The IDEA‐CF Knowledge Assessing Questionnaire (IDEA‐CF KAQ) scores in the intervention group improved compared with the IDEA‐CF KAQ scores in the control group, suggesting that education improves knowledge and understanding. The IDEA‐CF structured virtual group education group was well received, with participants valuing the educational content and the ability to interact with each other and to learn from their peers’ experiences constructively.Conclusions: Our study demonstrated that the IDEA‐CF education programme improved health‐related QoL and diabetes knowledge, as evidenced by the results of the IDEA‐CF KAQ. The participants valued the educational contents of the programme and reported a positive experience interacting with their peers.

Supporting caregivers of children living with disability in a humanitarian context: realist-informed evaluation of the ‘Mighty Children’ programme in Afghanistan

IntroductionTo ensure that humanitarian action is disability-inclusive, evidence is needed to understand how different strategies to support children living with disabilities and their families can work in these settings. Evidence...

Patients' experiences of a digital group education targeting kinesiophobia after myocardial infarction or atrial fibrillation - a qualitative pilot study

Abstract Background Fear of movement (kinesiophobia) is common among patients after a myocardial infarction or atrial fibrillation. The kinesiophobia is developed due to the patients’ beliefs that physical activity may cause re-injury. This negatively affects their ability to perform physical activity which is stated as the first line treatment in present guidelines. Purpose To explore how patients with myocardial infarction and/or atrial fibrillation experience participation in a digital group education targeting kinesiophobia and physical activity. Methods Seven women (55-81 years) with myocardial infarction and/or atrial fibrillation that had occurred at least 6 months earlier, and kinesiophobia, i.e., score of ≥ 37 on the Tampa Scale of Kinesiophobia Swedish Version for the Heart, were included. They took part in a digital program that was based on problem-based learning and cognitive behavioural therapy and delivered via a video conferencing platform over 8 weeks and supervised by a nurse or physiotherapist. The program covered topics such as myocardial infarction, atrial fibrillation, kinesiophobia, physical activity, and exposure. A digital platform with two-factor authentication for login was developed to provide educational materials, including tutorial group scenarios, streamed lectures, factual texts, and homework assignments. Individual semi-structured interviews were conducted with the women via a video conferencing platform after the 8-week program and transcripts were analysed using conventional qualitative content analysis. Preliminary results The women felt empowered after the digital encounters and joyful discussions with the group members. The educational materials and their own search for information, which was discussed in the group made them feel enlightened. The kinesiophobia was relieved or gone according to their experiences. This promoted the women to be physically active based on their own preferences. Initially, experiences of stress due to technical problems were felt. The tutor was attentive and enabling in guiding the women during the meetings on the video conferencing platform. Conclusions A digital group education targeting kinesiophobia after myocardial infarction and/or atrial fibrillation was experienced as feasible, enlightening, and empowering in a small group of women. The kinesiophobia was relieved or gone. This promoted them to perform physical activity as they preferred, and which is important for their recovery. More and larger studies are needed to show if a digital group educational program via a video conferencing platform can reduce kinesiophobia and promote physical activity after myocardial infarction or atrial fibrillation.

Study protocol for the implementation of Centering Patients with Fibroids, a novel group education and empowerment program for patients with symptomatic uterine fibroids.

Black women and people with uteri have utilized collectivistic and relational practices to improve health outcomes in the face of medical racism and discrimination for decades. However, there remains a need for interventions to improve outcomes of uterine fibroids, a condition that disproportionately impacts Black people with uteri. Leveraging personalized approaches alongside evidence that demonstrates the positive impact of social and peer support on health outcomes, we adapted from CenteringPregnancy, an evidence based group prenatal care intervention, for the education and empowerment of patients with uterine fibroids. The present report provides an overview of the study design and planned implementation of CPWF in cohorts at Boston Medical Center and Emory University / Grady Memorial Hospital. After receiving training from the Centering Healthcare Institute (CHI), we adapted the 10-session CenteringPregnancy curriculum to an 8-session hybrid group intervention called Centering Patients with Fibroids (CPWF). The study began in 2022 with planned recruitment of six cohorts of 10-12 participants at each institution. We will conduct a mixed methods evaluation of the program using validated survey tools and qualitative methods, including focus groups and 1:1 interviews. To date, we have successfully recruited 4 cohorts at Boston Medical Center and are actively implementing BMC Cohort 5 and the first cohort at Emory University / Grady Memorial Hospital. Evaluation of the program is forthcoming.

The experiences of family members attending an online addiction education program: a qualitative study

Family members of people experiencing addiction may experience increased stress and have difficulty coping with disrupted relationships, stigma, and isolation. Education programs for affected family members aim to assist in improving coping skills, understanding of addiction, and provide support, yet these have not been subjected to in-depth research, especially programs delivered by peers, or people with lived experience. This study explored the experiences of participants attending a BreakThrough online group education and support program for family members of people experiencing addiction. Twenty-one affected family members were interviewed and reflexive thematic analysis was used to develop three themes: experience of validation; not fixing, stepping back; and, education to help make sense of experiences. A topic summary was used to present data relating to the experiences of attending online. Participants experienced the group as validating and de-stigmatizing, thereby helping shift their approach to coping and consolidating their understanding of addiction. Participants reported being able to harness the collective insights of peers and make sense of their experiences through education and support. Education programs for affected family members, facilitated by peers, provide an opportunity for validation and ultimately serve to de-stigmatize addiction.

Gastrointestinal Group Education for Children and Adolescents with Functional Abdominal Pain Disorders—A Feasibility Study of a Brief Intervention

Functional abdominal pain disorders are common and disabling in children, but treatment options are limited. In a pilot study, we aimed to investigate if a brief group education program for pediatric patients with functional abdominal pain disorders and their parents is feasible and acceptable. Group education in adult irritable bowel syndrome has shown large treatment effects, but it has not been evaluated in children. The gastrointestinal (GI) group education, delivered in the clinic to 23 child–parent dyads, consisted of lectures by a pediatric gastroenterologist, a psychologist, and a dietician. Validated digital questionnaires were filled in by children and parents before and after the intervention. Most participants in the GI group education attended all sessions, and credibility in treatment was deemed high. Children’s self-reported knowledge of functional abdominal pain disorders increased, and improvements in gastrointestinal symptoms were reported at the end of this study. Our findings indicate that group education for children and adolescents with functional abdominal pain disorders, and their parents, is acceptable and feasible and may improve symptoms. A brief group education program may be of benefit in the management of pediatric functional abdominal pain disorders in several cases and when the family needs more knowledge than can be provided in primary care.

Knowledge and belongingness: experiences of a programme for parents of children with autism

ABSTRACT Background Whilst lack of social support has been associated with stress for parents of children with autism, group programmes for parents which bring together those with similar experiences and provide learning and resources can offer a form of social support. Although studies of such programmes suggest positive outcomes, including in terms of children’s adaptive behaviour, research examining parental perspectives on interventions that set out specifically to provide support to reduce stress in parents of children with autism is still scarce. Purpose Set in a Swedish context, the aim was to investigate whether a group education programme for parents of children with autism could be viewed as a site of informal social support and considered fertile ground for procuring social capital. Method Participants were parents of children who had been given an autism diagnosis at around three years of age. They had all taken part in a group education programme designed to facilitate experience-sharing in meetings between parents. The parents were interviewed about their experiences and perceptions of its influence on their everyday lives. Data were analysed qualitatively, using a Community of Practice lens. Findings The in-depth analysis indicated that, according to participants, the programme had helped alleviate feelings of isolation and improve parenting confidence. The findings speak to the importance of personal investment for knowledge acquisition and implementation, demonstrating the connections between the acquisition of social capital and membership of a Community of Practice. Conclusion Building on previous research emphasising the role of social support for the quality of life for parents of children with autism, the study highlights how a parental group education programme can represent a valuable social setting which is conducive for learning and resource procurement. Knowledge and belongingness in a social community – which enables access to, and sharing of, resources – are both of crucial relevance to outcomes and quality of life for families.

"It just made me feel better": qualitative examination of the implementation of a novel virtual psychosocial support program for adolescents with cancer.

Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact. We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens, and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programming in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents' and clinicians' acceptability, feasibility, and perceived utility. Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming, such as Teens4Teens, is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.

The PREDG study: A randomised controlled trial testing whether an educational intervention can prevent gestational weight gain in women with obesity

The PREDG trial was designed to study the influence of an educative program on gestational weight gain in women with pregestational obesity. Randomized controlled clinical trial (https://www.isrctn.com/ISRCTN61793947) in 169 women with pregestational obesity (BMI ≥30kg/m2). Women were randomized to participate in a group education program in nutrition and physical activity or conventional follow-up in a specialized Unit of Obesity and Pregnancy. The nutritional intervention was adjusted to prepregnancy BMI and to the physical activity intensity. Quality was based on the Mediterranean diet. Macronutrients were distributed as follows: 50% carbohydrates, 20% protein and 30% fat. Adequate gestational weight gain was defined between 5 and 9kg (IOM 2009). Mean gestational weight gain was compared between groups by using the T Student test and frequencies of adequate gestational weight gain were compared by using ꓫ2. Gestational weight gain was lower in the intervention group: 8 (4-11) vs 9.2 (6-13) kg, p 0.026. Gestational weight gain was below 9kg in 24 of 39 (61.5%) women of the intervention vs 10 of 41 (24.4%) of the control group (p 0.001). Regarding obstetric complications, there were 15 (8.3%) cases of gestational diabetes with no differences between the groups. There were 14 of 85 (18.2%) cases of gestational hypertension or preeclampsia in the intervention group compared with 26 of 84 (32.5%) in the control group (p 0.040). With reference to neonatal weight, there were 7 of 82 (8.5%) large for gestational age neonates in the intervention group compared with 15 of 79 (19.2%) in the control group (p 0.050). A group-based educative and structured intervention results in an adequate weight gain and lower rates of gestational hypertension, preeclampsia and large for gestational age neonates in pregnant women with obesity.

Development of a telemedicine group educational program for patients with heart failure: A delphi study

AimsEvidence regarding the most effective and feasible videoconferencing group educational program for patients with heart failure is still equivocal. This study aimed to reach consensus about the structure, acceptability, and feasibility of videoconferencing for people with heart failure in Jordan that improves access to healthcare and clinical outcomes. MethodsThere were two Delphi survey studies of three rounds each. Delphi one survey involved 32 healthcare staff, experienced in heart failure clinical practice and telehealth, to obtain a consensus of opinion on a proposed group videoconferencing program for patients with heart failure. Delphi two involved seven staff of the information technology center, experienced in videoconferencing and using supporting applications, to obtain their consensus on the current capabilities of the healthcare system and patients about information technology. Descriptive statistics were used for each item to determine whether consensus was achieved or not. Items that received 80% disagreement or 80% agreement of participants were not presented for re-rating in the third round, while the items that scored varying degrees of agreement were presented for experts for re-rating. ResultsIn Delphi one a group of items reached consensus regarding structure, factors influencing, and effectiveness of the videoconferencing program. In Delphi two, the findings indicated that videoconferencing modality is applicable and feasible in Jordan. ConclusionThis is the first study that addresses the equivocal evidence for the design and implementation of heart failure videoconferencing programs. The framework of the current proposed program can be utilized as a guideline to test or develop a future videoconference program.

N21 Patient education is (sometimes) better than cure

Abstract Background About half of all patients with Inflammatory Bowel Disease (IBD) experience Extra Intestinal Manifestations (EIMs)1. One of these EIMs are non-inflammatory joint complaints. Preliminary research2 has shown that IBD patients treated by Amsterdam university medical centers (UMC) experience a lack in pre-symptomatic patient education regarding these complaints. The patients interviewed in this preliminary study were all unaware of the possible development of these joint complaints in addition to their IBD. Methods A practice-oriented study was set up. Both qualitative and quantitative research techniques were used. Literature research into innovations for patient education was performed. Questionnaires were distributed among IBD patients in Amsterdam UMC to identify wishes and needs regarding patient education about non-inflammatory joint complaints. To determine how this education is provided elsewhere, questionnaires were distributed among caregivers of IBD patients in other Dutch hospitals. Results According to literature research, verbal education, information leaflets, informational websites, group education and educational programs contribute to an increased knowledge of disease in IBD patients. Surveyed IBD patients from Amsterdam UMC wish to be informed about non-inflammatory joint complaints via verbal education or by information leaflets and/or internet. Of the surveyed caregivers in other Dutch hospitals, the majority do not have educational materials and/or methods about (non-inflammatory) joint complaints. Information is given verbally by most of them. The innovation is an information leaflet entitled 'Joint complaints in IBD'. This can be used to support verbal patient education and can be used as a reference work. The leaflet is also offered via internet. Conclusion Offering the information leaflet 'Joint complaints in IBD' is an appropriate innovation that meets the wishes of IBD patients in Amsterdam UMC with regard to patient education about non-inflammatory joint complaints. The leaflet is preferably used to support verbal patient education and is subsequently given to the IBD patient as a reference work or offered via the internet. Content optimization is recommended. Afterwards, a pilot implementation can be set up. After implementation, further research is recommended to investigate whether the innovation actually contributes to optimization of pre-symptomatic patient education about non-inflammatory joint complaints.

FEASIBILITY OF THE ACTPLAN PROGRAM FOR AFRICAN-AMERICAN DEMENTIA CAREGIVERS: A SELF-DIRECTED MULTIMEDIA DELIVERY

Abstract African Americans (AA) are less likely than White Americans to complete advance care plans or end-of-life treatment documents. They face significantly greater risk of Alzheimer’s Disease, a silent epidemic for this population, and other dementias. The healthcare system’s lack of dementia support for AAs contributes to disparate care. A four-session caregiver group education program was conducted on advance care planning for AA dementia family providers. The program was based on Kolb’s Experiential Learning Model and initially found effective in an R01 study using in-person delivery by a professional. The present pilot assessed feasibility of delivering the program in a self-directed multimedia format without professional facilitation, using Session 1 on tube feeding decisions as the test session. Twenty-six AA dementia caregivers completed the session in groups of 5 to 8 at a church equipped with a large TV screen. On-screen prompts guided navigation through the program which included recorded lecture, slides, short videos on decision-making, and group discussions. Using quantitative and qualitative methods, pre-and post-survey instruments were administered and interviews conducted. Usability ratings averaged 84%. Knowledge and self-efficacy gains exceeded those of the R01, with a 35% increase in correct responses on knowledge items, versus 18% for the R01 subjects; and increase in perceived decisional self-efficacy of 31% versus 30% for the R01 subjects. Qualitative feedback was universally positive. These findings confirm the feasibility of the self-guided multimedia approach to delivery of the program. A large RCT is planned which, if successful, will support wide dissemination to AA caregivers in need.

A Web-Delivered, Clinician-Led Group Exercise Intervention for Older Adults With Type 2 Diabetes: Single-Arm Pre-Post Intervention.

BackgroundThe COVID-19 pandemic created unprecedented shifts in the way health programs and services are delivered. A national lockdown to prevent the spread of COVID-19 in Australia was introduced in March 2020. This lockdown included the closure of exercise clinics, fitness centers, and other community spaces, which, before the pandemic, were used to deliver Beat It. Beat It is an 8-week in-person, community-based, and clinician-led group exercise and education program for adults self-managing diabetes. To continue offering Beat It, it was adapted from an in-person program to a fully web-based supervised group exercise program for adults with type 2 diabetes (T2DM).ObjectiveThis study aims to assess whether the Beat It Online program produced comparable health outcomes to the Beat It in-person program in terms of improving physical fitness (muscular strength and power, aerobic endurance, balance, and flexibility) and waist circumference in older adults with T2DM.MethodsAustralians with T2DM who were aged ≥60 years were included. They were enrolled in Beat It Online, a twice-weekly supervised group exercise and education program conducted via videoconference over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. The adaptations to Beat It are reported using the Model for Adaptation, Design, and Impact, including the type of changes (what, where, when, and for whom), the criteria for making those changes (why and how), and the intended and unintended outcomes. The intended outcomes were comparable functional fitness as well as physical and mental health improvements across demographics and socioeconomic status.ResultsA total of 171 adults (mean 71, SD 5.6 years; n=54, 31.6% male) with T2DM were included in the study, with 40.4% (n=69) residing in lower socioeconomic areas. On the completion of the 8-week program, significant improvements in waist circumference, aerobic capacity, muscular strength, flexibility, and balance were observed in both male and female participants (all P<.001). The Model for Adaptation, Design, and Impact reports on 9 clinical, practical, and technical aspects of Beat It that were adapted for web-based delivery.ConclusionsThis study found that Beat It Online was just as effective as the in-person program. This adapted program produced comparable health benefits across demographics and socioeconomic status. This study offers important findings for practitioners and policy makers seeking to maintain independence of older people with T2DM, reversing frailty and maximizing functional and physical fitness, while improving overall quality of life. Beat It Online offers a flexible and inclusive solution with significant physical and mental health benefits to individuals. Further evaluation of Beat It (both in-person and Online) adapted for culturally and linguistically diverse communities will provide greater insights into the efficacy of this promising program.

Patients’ perspectives of the effects of a group-based therapeutic patient education program for bipolar disorder: a qualitative analysis

BackgroundFew qualitative studies have explored the impact of group-based psychoeducation programs from the perspective of patients with bipolar disorder, and no studies to date have examined the effects of such programs on patients’ personal recovery. The aim of this study was to explore the effects of a group therapeutic education program on the personal recovery of people with bipolar disorder and its determinants.MethodsThree professionals conducted semistructured interviews with 16 patients who participated in 9 weekly sessions of four separate bipolar therapeutic education programs. The interviews were transcribed verbatim and analyzed inductively by two of the professionals using the thematic analysis method.ResultsThree main themes emerged from the interviews: the elements of therapeutic education, the experience of therapeutic education and the changes facilitated by therapeutic education. The changes reported by the participants included the evolution of the patient’s relationship with the disorder, improvement in the patient’s knowledge of the disorder, improvement in disorder management throughout daily life in general, and development of psycho-social skills and social relationships.ConclusionsThis study provides support for the beneficial impact of group therapeutic education programs on the personal recovery of people with bipolar disorder. These programs improve all dimensions of recovery according to the CHIME model, with connectedness, hope and empowerment being the main dimensions impacted. Our results indicate that therapeutic group education programs can be beneficial for people with bipolar disorder at any point during their experience of the disorder, with the potential exception of periods of thymic decompensation.

Development of videoconferencing group educational program for patients with heart failure: A Delphi study.

Funding AcknowledgementsType of funding sources: None.BackgroundDuring the COVID-19 outbreak, videoconference technology can help people avoid physical contact and minimise the exposure of healthcare providers to sick people as well as respiratory secretions. Videoconferencing can be beneficial for people with chronic conditions (such as heart failure) who have restricted mobility, live in remote and rural areas, or experience social loneliness. However, evidence for the effectiveness of using internet videoconferencing and its components accounted for the positive outcomes (such as knowledge, quality of life, self-care, healthcare utilization) is still lacking.PurposeTo develop a feasible videoconferencing program for patients with heart failure that meets patients’ needs and preferences in Jordan.MethodsThe study involved two Delphi survey studies of three rounds each. The first Delphi survey involved 32 healthcare staff, with heart failure clinical experience, to obtain a consensus of opinion on a proposed group videoconferencing program for patients with heart failure. The second Delphi study involved seven staff of the information technology center, with experience in videoconferencing and using supporting applications, to obtain their consensus on the current capabilities, needs, barriers and facilitators of the healthcare system (providers) and patients (users) about information technology. For both Delphi studies, content analysis was used to analyze responses of participants in the first-Delphi round. Items resulting from the first-round analysis were summarized, listed, and rated (5-point Likert scale) in order to provide input and develop the second-round questionnaire. The percent agreement of participants was defined to be 80% or above to indicate their consensus.ResultsHealthcare providers prefer sessions to be led by the cardiologists and cardiac nurses, moving from simple to a complex topic, and the dose of information and frequency should be varied according to the needs and severity of heart failure. Videoconferencing strategy could improve patients’ satisfaction, knowledge and self-care, and adherence with their therapy plans. Jordan healthcare system has a capability to use videoconferencing strategy in Jordan.ConclusionThis study addresses the equivocal evidence for the effectiveness of using internet videoconferencing between healthcare provider and patients. Establishing an effective videoconferencing program assists with meeting patients’ needs and preferences, accessing healthcare during COVID-19, reducing travel burden/costs as well as the risk of exposure to the virus, and ultimately improving clinical outcomes. This study will capture attention of healthcare providers to perform further studies targeting videoconferencing heart failure management programs

Two-Year Follow-Up of a Transition-Specific Education Program for Young People With Chronic Conditions

PurposeThe transition to adulthood is a challenging process for young people (YP) with chronic conditions. Patient education can help to prepare them for autonomous disease management and transfer to adult healthcare services. In a previous controlled study, participation in the youth-specific group education program ModuS-T immediately improved transition-specific knowledge, competencies, and patient activation of YP with various chronic conditions. To evaluate whether these effects are long lasting, we questioned YP from the intervention group (IG) and the control group (CG; no program) 2 years after participation. MethodsStandardized questionnaires were used to assess YP’s transition-specific knowledge, competencies, patient activation, health-related quality of life, and medical care status at baseline and 2 years later. Repeated measurement covariance analyses were used for statistical testing. ResultsA total of 181 YP (109 IG, 72 CG) completed the questionnaires (60% of previous interviewees; mean age 20 years, 46% female). Compared to the CG, the IG reported significant improvements in transition-specific knowledge, competencies, and patient activation (p < .001) and lower parents’ responsibility for their condition (p = .004). The proportion of YP who had already transferred to adult health care was nearly the same (54% IG/56% CG), but the CG was more likely to lose access to medical care (6% IG/14% CG). There were no effects on health-related quality of life. DiscussionThe 1.5-day ModuS-T program has long-lasting positive effects on knowledge and competencies relevant for the transition of YP. Transition-specific patient education programs close an important care gap and should be integrated into standard care.

Group education programme for patients with adrenal insufficiency: evaluation based on patients experiences

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

P264 Bridging the gap: co-producing a virtual self-management programme for individuals living with axial spondyloarthritis

Abstract Background/Aims Despite the considerable impact axial spondyloarthritis (axSpA) has on quality of life, condition-specific group education programmes are not routinely offered. Many people with axSpA report feeling isolated and often have never met anyone else with the condition. In 2020, the National Axial Spondyloarthritis Society (NASS) worked with patients and rheumatology departments to co-produce a pilot self-management programme (SMP) to explore demand from and assess the impact on patients and healthcare professionals (HCPs). Methods NASS identified six NHS centres to host the pilot SMP sessions. These centres represented a range of axSpA services. HCPs invited their axSpA cohort to attend by post or e-mail and NASS invited local NASS members. Attendees booked online via private URL. NASS developed content following consultation with rheumatology HCPs and people living with axSpA. The first session covered pain, flares, fatigue and emotional wellbeing. Following attendee feedback, three centres hosted a second session on medication and exercise. One centre held a third session covering night pain, sleep and stress. Sessions were delivered via online meeting software and included teaching, group discussions, polls and exercise. HCPs of the host rheumatology departments led these sessions in tandem with NASS staff, one of whom has lived experience of axSpA. Content and format were continually reviewed and improved using feedback from attendees and HCPs (Table 1); feedback was gathered by email, informal focus groups and anonymous surveys. Results A total of 266 patients attended. 55% were female and 27% were aged under 45. 10% were diagnosed within the past year; 26% within the last 5 years; &amp;gt;50% more than 10 years ago. No attendees had previously attended a hospital axSpA SMP session. Conclusion There is demand from patients and HCPs for an axSpA virtual patient SMP. Co-producing the programme can be effective for: engaging with a range of patients; educating and empowering patients to self-manage their condition; building relationships between HCPs and patients; reducing patient isolation; enabling appropriate self-referral to rheumatology services. This pilot has informed our next steps to expand the online sessions to new centres and explore co-producing an e-learning programme. Disclosure Z.E. Clark: Grants/research support; National Axial Spondyloarthritis Society receives grant funding from AbbVie, Biogen, Eli Lilly, Janssen, Novartis, UCB. W. Gregory: Honoraria; Speaker, conference registration and advisory board fees from AbbVie, Pfizer, Novartis, UCB. A. Chan: Member of speakers’ bureau; UCB, Novartis, Sanofi, AbbVie, Jannsen. A. Coy: None. Z. Cox: None. S. Dickinson: Grants/research support; National Axial Spondyloarthritis Society receives grant funding from AbbVie, Biogen, Eli Lilly, Janssen, Novartis, UCB. K. Gaffney: Shareholder/stock ownership; SpA Academy. Honoraria; Novartis, AbbVie, UCB, Lilly, Pfizer, Biogen. Member of speakers’ bureau; Celltrion, Novartis, UCB, AbbVie. Grants/research support; NASS, AbbVie, Pfizer, UCB, Novartis, Lilly, Jannsen, Gilead, Biogen. Other; Meeting expenses: AbbVie, Lilly, Roche, Novartis, Pfizer, UCB. B. Harrison: None. H. Herbert: None. C. Lewis: None. C. McCoy: None. K. Noel: None. K. Porthouse: None. K. Rigler: None. K. Weight: None. T. Williams: None. D. Webb: Grants/research support; National Axial Spondyloarthritis Society receives grant funding from AbbVie, Biogen, Eli Lilly, Janssen, Novartis, UCB. L. Dunkley: Honoraria; Honoraria with UCB, AbbVie, Pfizer.

Composition and Validity of a Youth Cyber Ethics Group Education Program

인터넷으로 인한 여러 심각한 사회문제들이 대두되면서, 사이버 윤리 규범과 가치를 제고할 필요에 대한 목소리가 높아지고 있다. 더 나아가 사이버 공간에서 지켜야 할 도덕적 원리를 표면적으로 학습하는 수준에 머물기보다, 가치판단이 필요한 상황에서 주어진 문제를 비판적으로 이해하고 주체적으로 자신의 생각을 표현하는 주체적인 윤리적 의사결정이 강조되고 있다. 이러한 필요성을 바탕으로 본 연구에서는 윤리적 결정에 초점을 둔 사이버 윤리 구조화 집단 교육 프로그램을 구성 및 개발하였다. 대상자인 초기 청소년이 이해하기 적합한 프로그램을 구성하기 위하여, 프로그램 개발 절차에 따라 프로그램을 기획 및 수정하고 재구성하는 과정을 거쳤으며 이에 대한 효과를 검증하였다. 연구 결과는 다음과 같다. 효과성 검증 결과, 측정 시기에 따른 차이가 유의하게 나타났으며, 프로그램 참여 이후 참여 청소년들의 사이버 윤리의식이 평균 8.1% 향상된 것을 확인할 수 있었다. 또한 사이버 윤리의식 구인 별로 살펴보면 책임과 지식에서 측정 시기에 따른 유의한 변화가 나타났다. 마지막으로 구인 별 하위 척도의 결과를 살펴보면 시기에 따라서 책임의 책임 인지와 지식의 이용지식과 윤리지식에서 유의한 향상이 나타난 것을 확인할 수 있었다. 이러한 연구 결과를 통해 초기 청소년의 사이버 윤리교육에 대한 제안점을 도출하였다.

The effectiveness of a structured group education programme for people with established type 2 diabetes in a multi-ethnic population in primary care: A cluster randomised trial

Background and aimsStructured self-management education has been shown to be effective in type 2 diabetes (T2DM) but more research is needed to look at culturally appropriate programmes in ethnic minority groups, where prevalence of T2DM is higher and diagnosis earlier. The study tested the effectiveness of a group education programme for people with established T2DM in a multi-ethnic primary care population. Methods and resultsCluster randomised trial conducted in two multi-ethnic UK sites. Practices were randomised (1:1) to a structured T2DM group education programme or to continue with routine care. A culturally-adapted version was offered to South Asians, who formed the majority of ethnic minority participants. Other ethnic minority groups were invited to attend the standard programme. Primary outcome was change in HbA1c at 12 months. All analyses accounted for clustering and baseline value.367 participants (64(SD 10.8) years, 36% women, 34% from minority ethnic groups) were recruited from 31 clusters. At 12 months, there was no difference in mean change in HbA1c between the two groups (−0.10%; (95% CI: −0.37, 0.17). Subgroup analyses suggested the intervention was effective at lowering HbA1c in White European compared with ethnic minority groups. The intervention group lost more body weight than the control group (−0.82 kg at 6 months and −1.06 kg at 12 months; both p = 0.03). ConclusionOverall, the programme did not result in HbA1c improvement but in subgroup analysis, a beneficial effect occurred in White Europeans. Findings emphasise a need to develop and evaluate culturally-relevant programmes for ethnic minority groups.