Diabetes care provision: barriers, enablers and service needs of young adults with type 1 diabetes from a region of social disadvantage

Katherine Kibbey, Jane Speight, Jennifer Wong, Laura A Smith, Helena Jane Teede

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18 Citations (Scopus)

Abstract

Aims To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio-economic, multicultural region. Methods A cross-sectional survey targeted 357 young adults with Type 1 diabetes, aged 18?30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self-reported HbA1c , plus measures of diabetes-related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire). Results Eighty-six (24 ) responses were received [55 (64 ) female; mean SD age 24 4 years; diabetes duration 12 7 years; HbA1c 68 16 mmol/mol (8.4 1.5 )]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30 ), transportation (26 ) and cost (21 ). However, `a previous unsatisfactory diabetes health experience? was cited as a barrier by 27 . Enablers were largely matched to overcoming these barriers. Over 90 preferred a multidisciplinary team environment, close to home, with after-hours appointment times. Forty per cent reported severe diabetes-related distress, 19 reported moderate-to-severe depressive symptoms and 50 reported moderate-to-severe anxiety. Conclusions Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identi?able logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with ?exible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcome
Original languageEnglish
Pages (from-to)878 - 884
Number of pages7
JournalDiabetic Medicine
Volume30
Issue number7
DOIs
Publication statusPublished - 2013

Cite this

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title = "Diabetes care provision: barriers, enablers and service needs of young adults with type 1 diabetes from a region of social disadvantage",
abstract = "Aims To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio-economic, multicultural region. Methods A cross-sectional survey targeted 357 young adults with Type 1 diabetes, aged 18?30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self-reported HbA1c , plus measures of diabetes-related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire). Results Eighty-six (24 ) responses were received [55 (64 ) female; mean SD age 24 4 years; diabetes duration 12 7 years; HbA1c 68 16 mmol/mol (8.4 1.5 )]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30 ), transportation (26 ) and cost (21 ). However, `a previous unsatisfactory diabetes health experience? was cited as a barrier by 27 . Enablers were largely matched to overcoming these barriers. Over 90 preferred a multidisciplinary team environment, close to home, with after-hours appointment times. Forty per cent reported severe diabetes-related distress, 19 reported moderate-to-severe depressive symptoms and 50 reported moderate-to-severe anxiety. Conclusions Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identi?able logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with ?exible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcome",
author = "Katherine Kibbey and Jane Speight and Jennifer Wong and Smith, {Laura A} and Teede, {Helena Jane}",
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language = "English",
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pages = "878 -- 884",
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Diabetes care provision: barriers, enablers and service needs of young adults with type 1 diabetes from a region of social disadvantage. / Kibbey, Katherine; Speight, Jane; Wong, Jennifer; Smith, Laura A; Teede, Helena Jane.

In: Diabetic Medicine, Vol. 30, No. 7, 2013, p. 878 - 884.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Diabetes care provision: barriers, enablers and service needs of young adults with type 1 diabetes from a region of social disadvantage

AU - Kibbey, Katherine

AU - Speight, Jane

AU - Wong, Jennifer

AU - Smith, Laura A

AU - Teede, Helena Jane

PY - 2013

Y1 - 2013

N2 - Aims To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio-economic, multicultural region. Methods A cross-sectional survey targeted 357 young adults with Type 1 diabetes, aged 18?30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self-reported HbA1c , plus measures of diabetes-related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire). Results Eighty-six (24 ) responses were received [55 (64 ) female; mean SD age 24 4 years; diabetes duration 12 7 years; HbA1c 68 16 mmol/mol (8.4 1.5 )]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30 ), transportation (26 ) and cost (21 ). However, `a previous unsatisfactory diabetes health experience? was cited as a barrier by 27 . Enablers were largely matched to overcoming these barriers. Over 90 preferred a multidisciplinary team environment, close to home, with after-hours appointment times. Forty per cent reported severe diabetes-related distress, 19 reported moderate-to-severe depressive symptoms and 50 reported moderate-to-severe anxiety. Conclusions Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identi?able logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with ?exible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcome

AB - Aims To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio-economic, multicultural region. Methods A cross-sectional survey targeted 357 young adults with Type 1 diabetes, aged 18?30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self-reported HbA1c , plus measures of diabetes-related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire). Results Eighty-six (24 ) responses were received [55 (64 ) female; mean SD age 24 4 years; diabetes duration 12 7 years; HbA1c 68 16 mmol/mol (8.4 1.5 )]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30 ), transportation (26 ) and cost (21 ). However, `a previous unsatisfactory diabetes health experience? was cited as a barrier by 27 . Enablers were largely matched to overcoming these barriers. Over 90 preferred a multidisciplinary team environment, close to home, with after-hours appointment times. Forty per cent reported severe diabetes-related distress, 19 reported moderate-to-severe depressive symptoms and 50 reported moderate-to-severe anxiety. Conclusions Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identi?able logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with ?exible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcome

UR - http://onlinelibrary.wiley.com.ezproxy.lib.monash.edu.au/doi/10.1111/dme.12227/pdf

U2 - 10.1111/dme.12227

DO - 10.1111/dme.12227

M3 - Article

VL - 30

SP - 878

EP - 884

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 7

ER -