Barriers and Facilitators to Incorporating an Integrative Mind-Body Intervention in Youth With Type 2 Diabetes

JAACAP Open. 2024 Feb 15;2(3):208-216. doi: 10.1016/j.jaacop.2024.01.005. eCollection 2024 Sep.

Abstract

Objective: There has been little to no qualitative research done with adolescents and young adults (AYA) with type 2 diabetes (T2D) that can guide creation of interventions for this demographic. Using qualitative research methods, a novel mind-body intervention called Intervention for Early Onset Type 2 Diabetes (INTEND) has been developed for AYA aged 15 to 20 years, with the goal of improving self-management and coping skills, by enhancing routine care with augmented education coupled with mind-body skills.

Method: Qualitative interviews with AYA 15 to 20 years of age with T2D, their parents, and professionals caring specifically for this population were done through a focus group model. Transcripts were created, depersonalized, and coded using a Consensual Qualitative Research (CQR) method. Identified themes then guided the creation of course materials that included education about self-management of T2D and how to use the 4 mind-body technique toward self-care and regulation.

Results: The qualitative approach used in the development of this intervention revealed important findings in understanding key barriers faced by this group, key facilitators that improve their quality of life, and core components of an intervention that would be acceptable to them.

Conclusion: Results of this qualitative study helped craft an intervention tool that can subsequently be deployed and evaluated for effectiveness. Findings of the qualitative research model allow us to better understand the lived experience of AYA living with T2D.

Clinical guidance: •Stigma of type 2 diabetes in adolescents may interfere with patients' ability to adequately adhere to treatment recommendations•Clinicians need to identify social supports for adolescents with type 2 diabetes•Identifying family members and including them in treatment plans may help adolescents with type 2 diabetes.

Keywords: AYA; diabetes; mind–body; qualitative; self-management.

Plain language summary

Youth-onset type 2 diabetes is a growing epidemic associated with increased risk for mental health problems, but there is little research regarding tailored treatment options. This study examined data from key stakeholder input from 3 patients, 3 parents, and 6 healthcare professionals using focus groups and qualitative interviews, to identify themes that guided the development of a novel mind-body intervention. Adolescents, medical providers and guardians identified stigma, isolation, and difficulty coordinating medical care as barriers to care. The novel mind-body intervention addressing both physical and mental health was positively received by all stakeholders. Thess results indicate the acceptability of a novel treatment for this understudied and underserved population.