Development and validation of an Interactive Education Tool (IET) on insulin therapy for children and adolescents with type 1 diabetes mellitus

Abstract

The effective management of type 1 diabetes mellitus (T1DM) in children relies heavily on their understanding and perception of insulin therapy. Despite the established effectiveness of educational interventions in improving these aspects, there is a noticeable lack of age-appropriate educational tools specifically targeting children. The primary aim of this project was to develop an interactive educational tool tailored to children and adolescents aged 9 to 15 years with T1DM. The development process began with a thorough needs assessment and problem analysis, which comprised two initial studies (1) the scoping review examined 49 articles to identify components and outcomes of educational interventions that enhance glycemic control in children with t1dm. It found notable reductions in hba1c levels in 98% of studies, with 58% achieving statistical significance. Additionally, 75% showed improved diabetes knowledge, nearly half reported better diabetes management behaviors, and several noted enhanced psychological well-being. Quality of life and health status showed promising trends but were less consistently significant. (2) qualitative study: semi-structured interviews were conducted with 31 participants from Universiti Kebangsaan Malaysia children’s specialist hospital (HPKK-UKM) and king Faisal Specialist Hospital and Research Centre (KFSH&RC) in Riyadh, Saudi Arabia. The study identified four key themes regarding information needs: hypoglycemia and hyperglycemia, insulin therapy, injection technique, and other information needs like continuous glucose monitoring and future advances in insulin therapy. It also revealed challenges such as behavioral and psychological issues, difficulties in controlling glucose in specific situations, and other problems such as forgetfulness, peer shame, and injection site following the needs assessment, the third study focused on the development and validation of an interactive education tool. This process involved creating a booklet in English, validated by six experts for content, language, illustrations, layout, motivation, and cultural appropriateness. The booklet underwent two rounds of expert review and subsequent revisions. Augmented reality features were integrated, and the tool Interactive Education Tool (IET) was translated into Arabic and Malay. The final study involved user testing through pre- and post-questionnaires to evaluate the tool's usability and emotional impact. The study utilized questionnaires incorporating items from the Diabetes Management Questionnaire (DMQ) and additional assessments for knowledge and satisfaction. Fifty-eight participants were recruited from HPKK-UKM and KFSH&RC. The educational tool significantly enhanced knowledge scores, improved self-management practices, and generated positive emotional responses. Children found the tool well-designed, calming, enjoyable, and helpful. In conclusion, the educational tool provides an age-appropriate, interactive, and comprehensive resource for children with T1DM, with the potential to improve diabetes management and quality of life in this vulnerable group