An Exergames Program for Adolescents With Type 1 Diabetes: Qualitative Study of Acceptability.

Background: Numerous barriers to moderate to vigorous physical activity exist for youths with type 1 diabetes (T1D). The virtual exercise games for youth with T1D (ExerT1D) intervention implement synchronous support of moderate to vigorous physical activity including T1D peers and role models.

Objective: This study aims to understand the acceptability of this intervention to participants.

Methods: We conducted postprogram, semistructured, televideo interviews with participating youths to elicit perspectives on the 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 4 main thematic areas.

Results: All 15 participants provided interviews (aged 14-19 years; 2 nonbinary, 6 females; median hemoglobin A_1c level of 7.8% (IQR 7.4%-11.2%), 5 with a hemoglobin A_1c level of ≥10%). Qualitative data revealed four themes: (1) motivation to engage in physical activity (PA)-improving their physical capabilities and stabilizing glucose levels were cited as motivation for PA and 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 and sometimes preparing for PA involved psychological and motivational adjustments while some relayed feelings of avoidance; (3) peer support encouraged engagement with the intervention-participants appreciated the peer aspects of components of ExerT1D and participants' reflections of the facilitated group experience highlight many benefits of a small-group virtual program; and (4) improvements in PA and diabetes self-management efficacy-all participants credited the program with improving or at least 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, improved awareness of diabetes-specific tasks to prepare for exercise, and improved understanding of the effect of PA on glucose levels. Engaging youths with a virtual video game intervention is a viable approach to overcome barriers to PA for adolescents with T1D.

Trial registration: ClinicalTrials.gov NCT05163912; https://clinicaltrials.gov/ct2/show/NCT05163912.