Background: The transitional period of emerging adulthood (18-25 years), with its focus on identity development and establishing independence, places some youth at risk for poor type 1 diabetes (T1D) outcomes. Yet, there are few effective interventions that specifically target emerging adults with T1D. Emerging adults have technology integrated into their natural ecology and are reliant on mobile devices, demonstrating the utility of technology-based interventions.
Objective: The purpose of this study is to describe the development and initial evaluation of an eHealth intervention to improve T1D management in emerging adults with poor metabolic control.
Methods: The 3Ms is a two-session intervention to increase feelings of autonomy and motivate emerging adults to engage in their own diabetes care. Session 1 introduces 3 key diabetes care behaviors, The 3 Ms - Medication, Meter, and Meals – through psychoeducation and increases self-efficacy by providing strategies supporting T1D management. Session 2 reviews progress toward goal attainment, then reinforces participant success or bolsters motivation by reflecting on personal strengths. Ten emerging adults (16-25 years) diagnosed with T1D for at least six months with hemoglobin A1c (HbA1c) ≤ 9.0% reviewed the intervention and provided feedback via semi-structured interviews. Interviews were audio-recorded and transcribed for analysis. Using Framework Matrix analysis, two coders developed a consensus matrix to derive themes from the interview data.
Results: Two primary themes emerged from the data. Youth described experiences characteristic of the developmental tasks of emerging adulthood: a preference for autonomy, the process of identity assimilation, and the struggle to integrate themselves into “normal” settings. Participants’ impressions of the intervention characterized it as containing elements that were credible, relatable, and helpful reminders.
Conclusions: Emerging adults found The 3Ms to be acceptable and appropriate. Next steps will include testing intervention efficacy in a large-scale clinical trial.