Improving outcomes for adolescents with type 1 diabetes: the KICk-OFF structured education course

Summary

KICk-OFF is a five-day structured education course for 11- to 16-year-olds with type 1 diabetes. The aim of the course is to develop self-management skills around carbohydrate counting and insulin dose adjustment and to encourage participants to be able to manage their diabetes more effectively in everyday life. The curriculum was designed with input from school teachers to meet a variety of learning styles. When compared to ‘usual’ care, children involved in KICk-OFF have demonstrated improved quality of life measures and significant improvements in glycaemic outcomes.

Challenge

Self-management is an essential component of diabetes care but a literature review highlights generally poor quality research, with small sample sizes and short duration follow-up. Very few educational interventions for children and young people (CYP) have been shown to offer long-term benefit. However, in countries such as Germany, where repeated structured education is delivered by well-trained staff, an impressive improvement in mean HbA1c levels has been shown. In contrast, the glycaemic outcomes for children and young people in the UK remains static and depressingly poor, demonstrating a clear need for well-validated education packages, delivered by appropriately trained staff.

DAFNE courses for adults are an acknowledged intervention but nothing similar exists for CYP. The aim of KICk-OFF was to develop and evaluate a course designed to meet the learning needs of adolescents with Type 1 diabetes.

It has taken over 10 years to reach this final stage of the project, a cluster randomised controlled trial. Previous phases involved literature reviews, focus groups with CYP and families, theoretical modelling, producing a curriculum and a pilot evaluation. The curriculum has undergone revision as a result of the pilot evaluation and changes to current guidelines.

Objectives

The cluster randomised controlled trial aimed to discover whether participation in a KICk-OFF course improves biomedical and psychological outcomes for 11-16 year olds with Type 1 diabetes, and measure cost-effectiveness.

The curriculum is designed to be interactive and encourage experiential learning. It employs constructivist learning theory, building on existing knowledge and skills. It is delivered to up to eight young people at a time, in age banded groups (11-13 years and 14-16 years) and aims for participants to enjoy developing self-management skills and benefit from interaction with others. 

Teaching groups of young people for five consecutive days is a new experience for diabetes health care professionals. They need to be able to facilitate group work, manage challenging behaviour and ensure that each child reaches their learning objective.

To this end, a unique teaching skills course (delivered by Sheffield Hallam University) was created which includes a day spent in a secondary school observing and delivering group education. This course was attended by all staff (research and NHS) involved in the KICk-OFF study, has received excellent feedback and is now established as a generic course for health care staff.

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QiC Diabetes Winner 2013
Best improvement programme for children and young people
Improving outcomes for adolescents with type 1 diabetes: the KICk-OFF structured education course
by Sheffield Children’s NHS Foundation Trust

Contacts

Dr Katherine Price

Job title:
Consultant Paediatrician
Place of work:
Sheffield Children’s Hospital NHS Trust
Email:
kath.price@sch.nhs.uk

Resources

Final curriculum 2012 - 695.8 KB

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