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)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Electronic health literacy of parents caring for children with Type 1 diabetes: impact on disease management and outcome
ABSTRACT
Background:
Despite the growing uptake of smart technologies in pediatric Type 1 diabetes mellitus (T1DM) care, little is known about caregiving parents’ 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 children’s outcomes.
Methods:
A cross-sectional survey was performed involving 150 parent-child (8-14 years with T1DM) dyads in a university pediatric diabetology centre. Parents’ 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. Children’s 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. Parents’ average eHEALS score (31.2, SD=4.9) differed significantly by educational level and the children’s 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 children’s HbA1C, PedsQL Diab and EQ-5D-Y-3L outcomes. Regression analysis revealed significant associations between the child’s HbA1C level, sex, treatment modality and parents’ self-efficacy (PSESDM).
Conclusions:
Significantly higher parental eHealth was found in T1DM children using glucose sensor. eHealth level was associated with parents’ diabetes management attitude but not the child’s 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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