Identifying Potential Sustainable and Scalable Interventions to Recognize Signs of Diabetes in Children Across Canada.

Introduction: Delayed diagnosis of diabetes in children can lead to diabetic ketoacidosis, a life-threatening condition occurring in 10-80% of children at diabetes diagnosis. Ketoacidosis is preventable with prompt recognition of signs, urgent attendance to care, and rapid diagnosis and management. The objective of this study was to plan for the development of an intervention to recognize signs of diabetes in children and prevent ketoacidosis, that is evidence and theory-informed and has potential for widespread implementation and long-term impact across Canada.

Methods: This qualitative exploratory study included researchers, educators, parents, caregivers, and representatives from relevant healthcare organizations (n=41). Through targeted recruitment and snowball sampling, participants took part in a focus group or interview about opportunities to adapt, sustain, scale, and evaluate various diabetes awareness interventions. Transcripts were analyzed using content analysis to examine barriers and facilitators of potential interventions.

Results: Participants proposed several interventions, including using posters, magnets, educational take-home cards, and mass media to increase awareness about the signs of diabetes in children and the need to rapidly seek care to prevent a delayed diagnosis. Each strategy was noted to have advantages, such as refrigerator magnets being visible for a long time, and disadvantages, such as high-cost resources required for mass media. Participants also identified challenges in evaluating interventions and about how to tailor strategies for specific populations while remaining relevant across Canada.

Conclusion: This work informs the development, implementation, and evaluation of a Canadian strategy to recognize signs of diabetes in children and prevent a delay in diagnosis.