Technology knowledge optimization for type 1 diabetes in schools (TeKnO T1D: Schools): A Novel e-learning platform for school nurses to advance health outcomes

About This Grant

The standard of care for pediatric type 1 diabetes (T1D) is the use of continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems to optimize glycemia. These diabetes technologies hold the potential to decrease the risk of acute and long-term complications. Yet, the rapid developments over the last decade have posed challenges for youth, caregivers, and healthcare professionals who must learn to use these devices. Use of these devices requires significant user interaction and remains labor-intensive, leading to variability in glycemic outcomes. Up to 75% of youth may have higher hemoglobin A1c levels despite device use, placing them at increased risk for complications over time. Schools offer a unique opportunity to support these populations. Youth with T1D spend nearly one third of their weekdays in school under the care of school nurses. School nurses have expressed a critical gap in their knowledge of T1D devices, which can negatively affect parent and student school experiences. To date, little to no research has explored interventions to support school nurses with T1D devices. Structured education may directly impact school nurse CGM and AID knowledge and confidence and student outcomes. e-Learning, defined as the delivery of education through digital resources, allows for flexible, asynchronous learning at a self-determined pace. App-based CGM and AID education stimulates active, problem-centered learning that improves the knowledge and confidence of endocrinology trainees. We propose to adapt an existing diabetes technology e-Learning tool to meet the needs of school nurses using the Discover-Design-Build-Test framework. In the Discover phase (Aim 1), focus groups of school nurses, parents of youth with T1D, teens with T1D, and diabetes clinicians will be used to understand CGM and AID use in the school setting, individual and organizational challenges for school nurses learning to use devices and perceptions of nurse understanding of these devices. The Design and Build phases (Aim 2) will engage school nurses to adapt an existing app-delivered diabetes device curriculum using user-centered design and educational theory. We will conduct usability testing, seeking quantitative and qualitative feedback, to guide app refinement before proceeding to a pilot in Aim 3. Pilot outcomes will focus on feasibility and acceptability (primary), school nurse knowledge and confidence (secondary) and health and academic outcomes for students with T1D cared for by participating school nurses (exploratory). The e-Learning tool developed will be tested in future studies with the goal of implementing a widely disseminatable tool that can lead to sustainable systems-level change to improve school health.