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Accepted for/Published in: JMIR Diabetes

Date Submitted: Mar 10, 2022
Open Peer Review Period: Mar 3, 2022 - Apr 28, 2022
Date Accepted: Sep 1, 2022
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Implementation Plan for a High-Frequency, Low-Touch Care Model at Specialized Type 1 Diabetes Clinics: Model Development

de Sequeira S, Presseau J, Booth G, Lipscombe LL, Perkins I, Perkins BA, Shulman R, Lakhanpal G, Ivers N

Implementation Plan for a High-Frequency, Low-Touch Care Model at Specialized Type 1 Diabetes Clinics: Model Development

JMIR Diabetes 2022;7(4):e37715

DOI: 10.2196/37715

PMID: 36480257

PMCID: 9782362

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Developing a successful implementation plan for a high frequency, low touch care model at specialized type 1 diabetes clinics: The Type 1 diabetes virtual self-Management and Education support (T1ME) trial

  • Stephanie de Sequeira; 
  • Justin Presseau; 
  • Gillian Booth; 
  • Lorraine L. Lipscombe; 
  • Isabelle Perkins; 
  • Bruce A. Perkins; 
  • Rayzel Shulman; 
  • Gurpreet Lakhanpal; 
  • Noah Ivers

ABSTRACT

Background:

Individuals with type 1 diabetes (T1D) are more likely to achieve optimal glycemic control when they have frequent visits with their healthcare team. There is a potential benefit of frequent, telemedicine interventions as an effective strategy to lower hemoglobin A1c (HbA1c).

Objective:

To understand the provider- and system-level factors affecting successful implementation of a virtual care intervention into type 1 diabetes (T1D) clinics.

Methods:

Semi-structured interviews with managers and certified diabetes educators (CDEs) at diabetes clinics across Southern Ontario, prior to the COVID-19 pandemic. Deductive analysis using the Theoretical Domains Framework, then mapping to Behaviour Change Techniques to inform potential implementation strategies for high frequency virtual care for T1D.

Results:

There was considerable intention to deliver high frequency virtual care to patients with T1D. Participants believed that this model of care could lead to improved patient outcomes and engagement, but would likely increase the workload of CDEs. Some felt there were insufficient resources at their site to enable them to participate in the program. Member-checking conducted during the pandemic revealed that clinics and staff had already developed strategies to overcome resource barriers to the adoption of virtual care during the pandemic.

Conclusions:

Existing enablers for high frequency virtual care can be leveraged, and barriers can be overcome with targeted clinical incentives and support.


 Citation

Please cite as:

de Sequeira S, Presseau J, Booth G, Lipscombe LL, Perkins I, Perkins BA, Shulman R, Lakhanpal G, Ivers N

Implementation Plan for a High-Frequency, Low-Touch Care Model at Specialized Type 1 Diabetes Clinics: Model Development

JMIR Diabetes 2022;7(4):e37715

DOI: 10.2196/37715

PMID: 36480257

PMCID: 9782362

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