The findings are in people!
Good relationships between young adults with type 1 diabetes and their diabetes clinic team is associated with more regular clinic visits and more regular contacts with the diabetes clinic in between appointments. I am really excited about this finding because, although it is not mind-blowingly surprising, it provides evidence to support the development of diabetes services for young adults which prioritise partnership and teamwork.
The origin of the Your Diabetes Clinic Study
So where did this study come from? The aim of the Your Diabetes Clinic Study was to gain a better understanding of young adult’s experiences in their diabetes clinic and the reasons why they did or did not go to their clinic appointments. To do this, a questionnaire was put together based on the theory of clinic attendance behaviour, which we developed in an earlier study (please see my last Study Update for more information on the development of this theory!). Using statistics, the data provided by the wonderful young adults who completed our questionnaire, through this website, were analysed to determine what parts of the theory of clinic attendance were linked to the number of clinic visits made by participants.
So many questions!!
This study looked a number of different questions related to young adult’s interactions with their diabetes clinic. For example, do young adults who have better relationships with their diabetes team attend more appointments, miss fewer appointments, and have more informal contact (for example, telephone or e-mail contact) with the clinic? We also wanted to know whether negative emotions related to diabetes experienced by some young adults played a role in their interactions with the clinic. We were also interested in the influence of factors like young adult’s daily diabetes self-management activities, satisfaction with the diabetes clinic and quality of their social support on interactions with the diabetes clinic.
Collecting the data
So after about four months of collecting data online and in diabetes clinics in Ireland, 154 young adults completed the questionnaire. I would like to extend a sincere thanks to these participants and to all of the people who took an interest in this study and shared it online. Thanks also to the diabetes service providers around Ireland who very kindly supported me to recruit young adults attending their clinics. All that was left then was to get my statistics hat on and to analyse the data with the expert support of Dr Ronan Conway.
Favourite part…the findings!
In my excitement, I started this story with the ending; relationships between young adults and diabetes service providers emerged from the analysis as an important factor when it comes to getting to those clinic appointments. We also found that relationships play a role in the amount of informal contact, by e-mail or telephone for example, initiated by the participants.
We also found some other interesting things:
- Participants with better relationships with service providers were more likely to feel confident in their ability to deal with their diabetes, for example feeling more able to set realistic diabetes-related goals and get support when they needed it.
- A huge 82% of our participants made informal contact with their diabetes clinic by telephone, text message, e-mail, or calling into the clinic, at least once in the previous two years. Informal support seems really important but isn’t always an official part of diabetes services and so can be a lot of extra work for service providers and may not be accessed by all young adults.
- Many of the other variables we measured, like distress and attitudes towards diabetes self-management, did not play a big role in helping us to understand the factors which influence young adults to visit their diabetes clinic. This tells us that more work is needed to make sure we understand the full story here.
- We would usually assume that people who are satisfied with their healthcare are more likely to continue to go to their appointments. Our findings suggest that things are more complicated! We found that satisfaction wasn’t that important in relation to making all of your clinic appointments, but having a relationship with your diabetes team was. This finding tells me that even if there are issues with the clinic, such as long waiting times and less than swanky waiting areas, a good relationship can overcome these barriers and increase the likelihood of young adults making their appointments.
So what’s next??
Although there are many difficulties in our health systems, facilitating the development of strong working relationships seems like a worthwhile priority. Our study suggests that efforts to improve relationships between young adults and service providers could take at least two possible approaches: reduce existing barriers to relationship development, such as reducing the range of staff responsible for young adult diabetes services so that young adults can become familiar with the team, and support partnership, for example by training young adults and service providers to share decision-making and problem-solving. Developing ways to increase access to informal support between appointments might also be important.
We’re working hard at the moment to publish the findings of this study so that the results will be available to people working with young adults with type 1 diabetes. I am lucky enough to be attending the World Diabetes Congress in Vancouver at the beginning of December and will give a poster presentation on this study! I could not be more excited about this!! Finally, the findings of this study will form part of a national study I am part of which aims to design new approaches to providing diabetes services to young adults with type 1 diabetes. Keep an eye on developments from this exciting work!
PS Questions or thoughts? https://www.facebook.com/yourdiabetesclinic?ref=hl or tweet @LisaHynes19