Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Nov 22, 2023
Date Accepted: Jan 31, 2024
(closed for review but you can still tweet)
The impact of parental electronic health literacy on disease management and outcome in pediatric type 1 diabetes: results from a cross-sectional clinical study
ABSTRACT
Background:
Despite the growing uptake of smart technologies in pediatric Type 1 diabetes mellitus (T1DM) care, little is known about caregiving parentsâ skills to deal with electronic health information sources.
Objective:
We aimed to assess the electronic health literacy (eHealth) of parents caring for children with T1DM and investigate its associations with disease management and childrenâs outcomes.
Methods:
A cross-sectional survey was performed involving 150 parent-child (8-14 years with T1DM) dyads in a university pediatric diabetology centre. Parentsâ eHealth (eHealth Literacy Scale, eHEALS), general health literacy (Chew questionnaire; Newest Vital Sign, NVS) and attitudes towards T1DM care (Parental Self-Efficacy Scale for Diabetes Management scale, PSESDM; Hypoglycaemia Fear Survey, HFS) were investigated. Childrenâs treatment, HbA1C level and quality of life (Pediatric Quality of Life Inventory-Diabetes Module, PedsQL Diab; EQ-5D-Y-3L) were assessed. Multiple linear regression analysis was performed to investigate determining factors of 6-month average HbA1C.
Results:
Altogether, 38 (25.3%) children used pen, 55 (36.7%) pen+sensor, 6 (4.0%) insulin pump and 51 (34.0%) insulin pump+sensor. Parentsâ average eHEALS score (31.2, SD=4.9) differed significantly by educational level and the childrenâs treatment, being the highest in the pump+sensor subgroup. Pearson correlations were significant between eHEALS and the Chew, NVS and PSESDM scores but not with childrenâs HbA1C, PedsQL Diab and EQ-5D-Y-3L outcomes. Regression analysis revealed significant associations between the childâs HbA1C level, sex, treatment modality and parentsâ self-efficacy (PSESDM).
Conclusions:
Significantly higher parental eHealth was found in T1DM children using glucose sensor. eHealth level was associated with parentsâ diabetes management attitude but not the childâs glycemic control. Studies that investigate further the role of parental eHealth in T1DM children managed at different levels of care and local context are encouraged.
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