Grant: Project Grant

Emerging adulthood, the transition period between childhood and adulthood, is a life stage that is challenging even for those without medical illness. For those with diabetes they must additionally learn to take responsibility for their own health. At this time, emerging adults (ages 18-30 years old) also move from pediatric to adult medical healthcare systems. This transition period places them at risk for disengaging from the healthcare system, only to return with diabetes-related complications. Despite the recognized importance of transition care, the medical literature on this topic is limited. At this moment, we know little about how to provide transition care services to emerging adults with diabetes. We propose to examine group education visits as an alternative and potentially cost-effective approach. Such visits have the potential to enhance peer-to-peer support. We will study if group education visits better prepare emerging adults for adult care and reduces their risk of complications as compared to usual care. We will conduct a prospective, randomized, allocation-concealed, single blind controlled trial of adolescents with diabetes (ages 17 years +/- 3 months) followed at one of the two university hospital-based pediatric diabetes clinics in Montreal. Interventions will occur over 12-months. Follow-up will be to 24 months from enrollment. Visits in the active arm will consist of a group education visits (every 3 months) followed by an individual appointment with the patient's diabetes physician. The group session, facilitated by a diabetes nurse educator, will be a patient-driven discussion on topics relevant to adolescents with diabetes. Patients in the control arm, will have in parallel, individual appointments with their diabetes physician as per usual care. Ultimately, our study can serve as a foundational step in guiding the development of transition care services across all childhood-onset chronic diseases.