Physical activity among children with type 1 diabetes : an exploration of children's experiences and development of an intervention to promote self-efficacy and participation

• Main Author: Quirk, Helen
• Published: University of Nottingham 2016
• Subjects: 362.19892; WK Endocrine system
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.689877

Regular physical activity among children with Type 1 Diabetes Mellitus (T1DM) can help optimise long-term health outcomes. This thesis explores the experience of physical activity among children aged 9-11 years with T1DM and their parents, develops a physical activity intervention and evaluates its feasibility. Social cognitive theories have been drawn upon to develop our understanding and inform theoretically-driven behaviour change strategies. First, a systematic review with meta-analysis evaluates existing physical activity interventions for children with T1DM. The findings confirm the health benefits associated with regular physical activity, including improved glycaemic control and lipid profile. Gaps in the existing literature are identified, such as the need for theoretically-driven interventions. Second, the experience of physical activity for children with T1DM from the perspective of i) parents and ii) paediatric diabetes healthcare professionals are explored. Qualitative research findings highlight the challenges faced, as well as the methods used by families to overcome obstacles to physical activity. Healthcare professionals recognise their role in promoting physical activity, but perceive barriers to the successful fulfilment of this role. Third, the feasibility and acceptability of wrist-worn ActiGraph GT3X+ accelerometers in children with T1DM is explored. The findings demonstrate that the accelerometer is feasible, acceptable, sensitive to change and objective data correlates with self-reported physical activity. Fourth, correlates of physical activity are explored alongside children’s values, beliefs and expectations. The findings suggest that self-efficacy and enjoyment have a role in physical activity and children perceive few diabetes-related barriers to participation. Finally, the feasibility and acceptability of the Steps To Active Kids-Diabetes (STAK-D) programme for children with T1DM is explored using mixed-methods. The capacity to detect change over time in selected health outcomes is also explored (e.g., physical activity level, self-efficacy and parental fear of hypoglycaemia) All findings are discussed in terms of their implications for knowledge and understanding, a future definitive trial and clinical practice.