One on One: Providing vital support to parents and adolescents BackgroundThe transition from childhood to adolescence can be a challenging time for any child and their parents. This is especially so for children and teenagers with type 1 diabetes. In addition to the general challenges experienced in adolescence, young people with type 1 diabetes are also taking increased responsibility for their diabetes management as well as transitioning into the adult health care system. This transition period is known to impact both parent and child, with both experiencing impaired emotional wellbeing including moderate to severe anxiety[1]. Providing support to both young people with diabetes and their parents to help them navigate this transition period is vital to ensure optimal diabetes management. The Diabetes MILES Youth Study 2014 survey provides a national snapshot of the emotional well-being, general health and psychosocial issues facing young people with type 1 or type 2 diabetes and their parents.This report found that parents of children with diabetes are at increased risk of anxiety and depression. Parents major concerns were around hypoglycaemia at night and that parents worried about their child developing complications and feeling like they were the u201cdiabetes policeu201d with their child.The transition from childhood to adolescence can be a challenging time for any child and their parents. This is especially so for children and teenagers with type 1 diabetes.It is recognised that children with diabetes often start to rebel against the diabetes management routine at this time. This could be for many reasons, including that they do not want to appear u2018differentu2019 from their friends. They may want to be more independent of their own lives and not have their parents so involved.Body image concerns may arise at this time and may impact on diabetes management. Diabetes may also contribute to self-confidence issues.During the transition period, the responsibility for diabetes management will move from the parents to the teenager. This responsibility may put pressure on the teenager, especially as they experience frustrations relating to unpredictable or changing blood glucose levels (BGLs), despite their best efforts. Anecdotal reports to Diabetes Queensland and information obtained through research demonstrates that parents are often concerned about their teenageru2019s health during this transition period, including relating to diabetes management, mental health. Parents often feel that they are being distanced and do not know how to approach their child to discuss their concerns.AimsThe One on One program aims to improve confidence among both young people with diabetes and their parents to navigate the transition into adulthood and help to establish supportive relationships both between parent and child as well as among peers. Increased awareness of diabetes and diabetes management for parents of type 1 children whilst transitioning into adulthood.The parents who attend the session benefit from the peer support offered to feel more connected and less isolated in their experiences relating to their child with diabetesThis program is designed to engage a Psychologist who facilitates discussion and provides parents with information and strategies to assist them and their child through this transition time. The program also provides a peer support opportunity for the type 1 child, allowing them to meet others in the same situation, to share experiences and to feel less isolated.MethodsYoung people with type 1 diabetes aged from 9 to 16, and their parents, attend a tailored education session delivered in collaboration with the local health care team who provide services to young people with type 1 diabetes. The session also includes presentations from local young adults with type 1 diabetes who share their experiences and insights in their own transition into adulthood with the condition. To allow for the development of peer relationships and the delivery of targeted information, parents and children are separated for part of the session with children partaking in engaging relationship-building activities and parents having an opportunity to discuss relevant issues with other parents in the presence of a psychologist and or an endocrinologist and a credentialled diabetes educator. Opportunity for open discussion of parents concerns, identifying similarities which assists with the feeling of community and support. Open discussion between the parents and the health team to look at strategies to assist with the transition period. The children whilst away from the parents are engaged in building a support network with other children of similar age who also have type 1 diabetes.Having the local health team involved is important as they hear the concerns of the parents and the strategies discussed so when going back to clinical practice they can assist in the implementation to support transition to adulthood [2].ResultsThe program has been successful in increasing confidence among both parents and young people in navigating the transition into adulthood with type 1 diabetes. The sessions have also facilitated on going peer support relationships and mechanisms both between young people and between parents. Positive feedback for the program with over 90% of respondents recommending this evening to other parents of a child with type 1 diabetesAn overwhelming majority of participants completing the evaluation were satisfied with the program they attended, with more than 95% of NDSS registrants overall agreeing the sessions they attended met their needs in terms of what they were hoping to learn or achieve.An overwhelming majority of participants completing the evaluation felt the program increased their awareness of the NDSS, with more than 89% of respondents overall agreeing with this statement. Attendees at events are asked to rate the speakers in terms of ease of understanding and usefulness of information. These are useful measures of whether the seminar was adequately aimed at the target group and whether it has been successful in meeting set objectives. Overall, for NDSS registrant sessions, more than 95% of responses indicated speakers were easy to understand and over 95% of responses that participants were provided with information they can use [3].Feedback from previous events as well as other Diabetes Queensland programs and research, indicates that parents of children with type 1 find it useful to hear from older adolescents or young adults about their diabetes experience through the teenage years. DiscussionSupport to both parents and young people navigating the transition into adulthood, with the added pressures of managing a complex condition like type 1 diabetes, is an important strategy to improve emotional wellbeing and diabetes management outcomes. The One on One program is an example of an effective program providing tailored support to both parent and young person.References1.tSpeight, J., et al., Diabetes MILES Youth Study 2014 Survey Report. 2015, Diabetes Victoria: Victoria, Australia.2. Ersig, L.; Tsalikian, E; Coffey, J; Williams, K. Stressors in Teens with Type 1 Diabetes and Their Parents: Immediate and Long-Term Implications for Transition to Self-Management. Journal of Pediatric Nursing, Jul/Aug 2016; 31(4): 390-396. 3. NDSS National evaluation framework 2016 17 end of year report.