Accepted for/Published in: JMIR Diabetes
Date Submitted: Aug 21, 2024
Open Peer Review Period: Aug 22, 2024 - Oct 17, 2024
Date Accepted: Mar 20, 2025
Date Submitted to PubMed: Apr 16, 2025
(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Warning: This is an author submission that is not peer-reviewed or edited.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.
An Exergames Program for Adolescents with Type 1 Diabetes: A Qualitative Study of Acceptability
ABSTRACT
Background:
Numerous barriers to moderate and vigorous physical activity (MVPA) exist for youth with type 1 diabetes (T1D). The virtual exercise games for youth with T1D (ExerT1D) intervention implements synchronous support of MVPA including T1D peers and role models.
Objective:
To understand the acceptability of this intervention to participants.
Methods:
We conducted post-program, semi-structured, televideo interviews with participating youth to elicit perspectives on acceptability of the intervention and experience with the program. Two coders independently reviewed and analyzed each transcript using a coding scheme developed inductively by senior researchers. Discrepancies were resolved by team discussion, and multiple codes were grouped together to produce four main thematic areas.
Results:
All 15 participants provided interviews [14-19 years old; 2 non-binary, 6 females; 7.8% median HbA1c, 5 with HbA1c≥10.0%]. Qualitative data revealed four themes. (1) Motivation to engage in PA: Improving their physical capabilities and/or stabilizing glucose levels were cited as motivation for PA. Challenges of living with T1D were cited as PA barriers. (2) Experience with and motivation to manage diabetes while engaging in PA: Participants provided details of accommodating the inherent uncertainty or limitations of PA with diabetes. Sometimes preparing for PA involved psychological and motivational adjustments. Some relayed feelings of avoidance. (3) Peer support encouraged engagement with the intervention: Participants appreciated the peer aspects of components of ExerT1D. Participants’ reflections of the facilitated group experience highlight many benefits of a small-group virtual program. (4) Improvements in PA and diabetes self-management efficacy: All participants credited the program with improving and/or raising awareness of T1D management skills.
Conclusions:
Our virtual PA intervention using an active video game and discussion component provided adolescents with T1D the confidence and peer support to engage in PA, improve awareness of diabetes-specific tasks to prepare for exercise, and improved understanding of the effect of PA on glucose levels. Engaging youth with a virtual videogame intervention is a viable approach to overcome barriers to PA for adolescents with T1D. Clinical Trial: Interviewed participants of clinical trial NCT05163912
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