The process of developing and pretesting narrative messages for adolescents with type 1 diabetes

BackgroundThere is a growing need for healthcare providers to effectively communicate with adolescents with type 1 diabetes (T1D). However, past efforts have been ineffective and fail to break from didactic and directive language. There also a need for clear guidance on the process for developing effective messages that healthcare providers can use as educational and motivational materials in clinical practice.MethodsThis study outlines the steps and reasoning behind using narratives (e.g. first-person testimonials) as an effective message form for T1D management. This process involved theoretical principles, narrative creation based on real stories from young adults who grew up with T1D, and input from healthcare providers at a top-ranked pediatric endocrinology clinic. After message development, eight adolescents with T1D evaluated the messages in semi-structured interviews.ResultsThe narratives were built upon constructs of social cognitive theory and the health belief model, with overarching themes of feelings upon diagnosis, ongoing challenges, steps to overcome barriers, and long-term outcome expectations. Healthcare providers offered clinical recommendations to be integrated, including increased blood glucose monitoring; open communication with important others about the disease, including friends and healthcare providers; and greater feelings of optimism and T1D acceptance. Adolescents viewed the messages to be realistic, motivational, and potentially effective tools for self-management.ConclusionsThis formative research offers a step-by-step approach for developing T1D narratives, a novel way to reach adolescents with motivational messages. This work can act as a model to help address potential barriers facing adolescents and encourage behaviors that promote successful self-management.