Breathing Fresh Air into Diabetes Education: A Qualitative Study

Type 1 diabetes (T1D) is an endocrine and metabolic disorder affecting approximately 1.4 million adults living in the United States. Psychosocial factors have been identified as key barriers to improvements in self-care among T1D adults, including emotional well-being, social support and self-efficacy, and personal motivation. It is posited that nonclinical approaches, such as peer-based outdoor adventure education programs, could assist T1D adults with their individual psychosocial needs. However, very little research exists to support this unique approach to care. The purpose of this study was to explore the meaning that adults living with T1D ascribe to participation in a wilderness backpacking trip. Eighteen participants with T1D completed a 5-day backpacking trip on the Chilkoot Trail in Alaska and British Columbia. Once on the trip, participants were invited to participate in two semi-structured interviews within 48 hours of the trip start and end date. Using a phenomenological approach, three themes were constructed: a) seeking and finding a diabetes community, b) revealing capabilities to yourself and the world, and c) enhancing diabetes management and self-care on the trail and in life. A common thread across the three constructed themes was the sense of belonging to the diabetes community, which was described by the participants as paramount to their positive overall trip experience. This finding extends assertions that peer relationships during OAE programs may play a central role in improving psychosocial functioning for individuals living with T1D. This provides evidence on the power of using outdoor recreation to positively impact the community of individuals with T1D.