Grant: Op. Gr.:Diabetes, Psychosocial Health, Prev./Self-Manag. - CIHR-JDRF Pool in T1D

The transition period from pediatric to adult care is a vulnerable and challenging period for teenagers with type 1 diabetes. It is a vulnerable time because many teenagers struggle with a new and unfamiliar adult health care system, as well as struggle with the stressful changes that occur with growing up (i.e., increased responsibilities for their diabetes, independence, graduating from high school, etc.,). In Canada, it has been noted that many teenagers drop out of care soon during transition from pediatric to adult care. Unfortunately, this loss of follow-up results in an increase in both short and long term diabetes complications. To address this gap and improve continuity of care, in 2013 we started speaking with teenagers and young adults with type 1 diabetes, their families, as well as pediatric and adult doctors and nurses, to gain a better understanding of how to better serve teenagers' needs. We then used this information and developed a program for transition which included a transition coordinator and the use of communication technologies which are highly used by teenagers. The transition coordinator connected with teenagers by texting, with emails or by phone as well as encouraged the use of a diabetes specific transition website and a private Facebook page. We then assessed the effect of this transition program in a pilot study of 200 teenagers and found it t be very successful. Clinic attendance increased by 4 times and blood glucose improved in teenagers with suboptimal glucose control. We now aim to spread and scale this transition program to 5 major sites in Alberta. We will study if the transition program is successful again, how to best support the uptake of the program in communities we spread it to, and the cost savings of the program. Importantly, we will also develop a free, online guide (a toolkit), so other communities across Canada may carry out a program like this, so more teenagers with type 1 diabetes may benefit.