Rationale: Empowering adolescents with type 1 diabetes (T1D) to increase daily physical
activity (a cornerstone behaviour in diabetes self-management) is well-defined knowledge
gap in pediatric endocrinology clinical practice. Adopting a lifestyle that includes
regular physical activity (PA) is essential for the optimal health and quality of life
(QoL) of adolescents living with T1D, however Diabetes Canada clinical practice
guidelines provide no evidence for optimal behavioural approaches for achieving the
extensive self-management behaviours needed to prevent diabetes-related complications
during a critical stage of psychological, social and emotional development. As such,
daily PA levels remain low in adolescents with T1D and many do not meet current
recommendations for daily PA. The aim of this pilot trial is to assess the feasibility,
preliminary efficacy and safety of a novel peer-led behavioural intervention to increase
PA and quality of life for adolescents living with T1D.
Methodology: Investigators will conduct a pilot randomized controlled trial comparing a
peer-led, behavioural intervention, to standard of care on daily PA and quality of life.
Investigators will also conduct a qualitative study within the trial to understand the
contextual factors that influenced the peer mentoring approach to empowering adolescents
with T1D.
Population: Sixty adolescents 13-17 years of age living with T1D from 2 sites in Canada
who will be randomized 2:1 to intervention or control arms, respectively.
Intervention Arm: A 12-week behavioural intervention guided by the tenets of
self-determination theory, and led by a physically active young adult mentors, 21-30 yrs
of age living with T1D. Mentors will rely on motivational interviewing skills to support
adolescents living with T1D to increase daily PA by fostering a sense of autonomy for
goal setting and self-management skill acquisition, competency in their ability to
increase daily PA without compromising glucose management and a sense of relatedness to a
community of adolescents overcoming similar challenges.
Control Arm: Adolescents in the wait-list control arm will receive standard clinical
recommendations to increase daily PA.
Investigators will also conduct a qualitative study with 10 adolescents who participated
in the intervention. The qualitative component will attempt to (1) identify the complex
factors that influenced adherence to the intervention; (2) determine the appropriateness
and relevance of peer mentoring for adolescents with T1D; (3) explore sex, gender and
psychosocial-specific factors related to the delivery of the peer mentoring intervention;
and (4) explore possible novel mediators of the effect of the study arms on psychosocial
health, quality of life and health behaviours.
Timing: Feasibility and fidelity outcomes will be assessed throughout the trial and at
the 12-week time point.
Patient-engagement: Patient co-researchers from Canada and Ireland participated in
several formative studies that informed this proposal. They co-designed the novel
peer-led intervention and all aspects of the trial outlined in this proposal.
Importance: The results of this trial will inform a larger trial to provide much needed
empirical evidence for inform pediatric diabetes clinical practice guidelines for
behavioural strategies to improve self management and quality of life for adolescents
living with T1D.