Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents

Wysocki, Tim; Hirschfeld, Fiona; Miller, L. Paul; Izenberg, Neil; Dowshen, Steven A.; Taylor, Alex; Milkes, Amy; Shinseki, Michelle T.; Bejarano, Carolina M.; Kozikowski, Chelsea; Kowal, Karen; Starr-Ashton, Penny; Ross, Judith L.; Kummer, Mark; Carakushansky, Mauri; Lyness, D’Arcy; Brinkman, William B.; Pierce, Jessica; Fiks, Alexander G.; Christofferson, Jennifer; Rafalko, Jessica; Lawson, Margaret L.

doi:10.1177/0145721716647492

Cited by 31 publications

(72 citation statements)

References 58 publications

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“…When the initial search was repeated with ‘qualitative’ as the refining search term, 13 articles were found, reduced to 10 research based articles, and 7 selected for further review. Search 2 and 3 combined yielded a total of nine articles included in this meta‐synthesis .…”

Section: Resultsmentioning

confidence: 99%

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Best friend or spy: a qualitative meta‐synthesis on the impact of continuous glucose monitoring on life with Type 1 diabetes

Messer

Johnson

Driscoll³

et al. 2017

Diabet. Med.

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CGM affects physical, emotional and relational aspects of life. Clinicians can help minimize the burden of CGM with carefully delivered education and expectation-setting with individuals. Empowerment and relational partnerships in diabetes care can be explored to maximize satisfaction with CGM. Systematic interpretive synthesis of qualitative studies provides a comprehensive, contextual understanding of the impact of CGM on daily life and relationships.

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Section: Resultsmentioning

confidence: 99%

“…CGM users are impacted by the size of the device . The CGM transmitter is particularly large and disruptive, more than an insulin pump infusion set which is similarly affixed to the skin .…”

Section: Resultsmentioning

confidence: 99%

Best friend or spy: a qualitative meta‐synthesis on the impact of continuous glucose monitoring on life with Type 1 diabetes

Messer

Johnson

Driscoll³

et al. 2017

Diabet. Med.

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“…Distress related to not knowing if continuation of CGM use will be possible when financial difficulties arise also occurs [75]. Adolescents have reported being concerned about losing CGMs because it is expensive [69, 77]. Overall, the ongoing expenses associated with CGM can lead to distress about finances as well as uncertainty about whether individuals can sustainably afford CGM for ongoing T1D management.…”

Section: Biopsychosocial Factors Associated With Cgm and Insulin Pumpmentioning

confidence: 99%

“…Thirty-two percent of adult users in the USA who discontinued CGMs reported alarms as a primary reason for discontinuation [19]. Individuals with T1D also report concerns related to CGMs alarming at inconvenient times or causing unwanted attention to T1D at school, work, or personal settings and disturbing sleep [69, 77, 80]. While the frequency of alerts may be a nuisance in itself, it is also likely that alerts due to inaccurate readings cause additional frustration [19].…”

Section: Biopsychosocial Factors Associated With Cgm and Insulin Pumpmentioning

confidence: 99%

Biopsychosocial Factors Associated With Satisfaction and Sustained Use of Artificial Pancreas Technology and Its Components: a Call to the Technology Field

et al. 2018

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Purpose of Review Summarize biopsychosocial factors associated with using continuous glucose monitors (CGMs), insulin pumps, and artificial pancreas (AP) systems and provide a “call to the field” about their importance to technology uptake and maintained use. Recent Findings Insulin pumps and CGMs are becoming standard of care for individuals with type 1 diabetes (T1D). AP systems combining a CGM, insulin pump, and automated dosing algorithm are available for commercial use. Despite improved glycemic control with AP system use, numerous barriers exist which may limit their benefit. Studies on components of AP systems (pumps, CGMs) are limited and demonstrate mixed results of their impact on fear of hypoglycemia, adherence, quality of life, depression and anxiety, and diabetes distress. Studies examining biopsychological factors associated specifically with sustained use of AP systems are also sparse. Summary Biological, psychological and social impacts of AP systems have been understudied and the information they provide has not been capitalized upon.

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“…At the end of each section, 2 to 3 multiple-choice questions were presented which must be answered before proceeding to the next section. We included quizzes because adolescents prefer quizzes as a means for interaction [38], quizzes provide an opportunity to “teach to goal” [39] or improve comprehension of consent information, and quizzes are another suggested e-learning strategy [19]. …”

Section: Methodsmentioning

confidence: 99%

A cognitive approach for design of a multimedia informed consent video and website in pediatric research

Antal¹,

Bunnell

McCahan

et al. 2017

Journal of Biomedical Informatics

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Objective Poor participant comprehension of research procedures following the conventional face-to-face consent process for biomedical research is common. We describe the development of a multimedia informed consent video and website that incorporates cognitive strategies to enhance comprehension of study related material directed to parents and adolescents. Materials and methods A multidisciplinary team was assembled for development of the video and website that included human subjects professionals; psychologist researchers; institutional video and web developers; bioinformaticians and programmers; and parent and adolescent stakeholders. Five learning strategies that included Sensory-Modality view, Coherence, Signaling, Redundancy, and Personalization were integrated into a 15-minute video and website material that describes a clinical research trial. Results A diverse team collaborated extensively over 15 months to design and build a multimedia platform for obtaining parental permission and adolescent assent for participant in as asthma clinical trial. Examples of the learning principles included, having a narrator describe what was being viewed on the video (sensory-modality); eliminating unnecessary text and graphics (coherence); having the initial portion of the video explain the sections of the video to be viewed (signaling); avoiding simultaneous presentation of text and graphics (redundancy); and having a consistent narrator throughout the video (personalization). Discussion Existing conventional and multimedia processes for obtaining research informed consent have not actively incorporated basic principles of human cognition and learning in the design and implementation of these processes. The present paper illustrates how this can be achieved, setting the stage for rigorous evaluation of potential benefits such as improved comprehension, satisfaction with the consent process, and completion of research objectives. Conclusion New consent strategies that have an integrated cognitive approach need to be developed and tested in controlled trials.

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Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents

Abstract: Stakeholder-driven development of multimedia, web-based decision aids requires meticulous attention to detail but can yield exceptional resources for adolescents and parents contemplating major changes to their diabetes regimens.

Cited by 31 publications

References 58 publications

Best friend or spy: a qualitative meta‐synthesis on the impact of continuous glucose monitoring on life with Type 1 diabetes

Best friend or spy: a qualitative meta‐synthesis on the impact of continuous glucose monitoring on life with Type 1 diabetes

Biopsychosocial Factors Associated With Satisfaction and Sustained Use of Artificial Pancreas Technology and Its Components: a Call to the Technology Field

A cognitive approach for design of a multimedia informed consent video and website in pediatric research

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