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Development and feasibility testing of a webpage-based diabetes education in adolescents with type 1 diabetes mellitus in China

Zhao, Xiaolei


Xiaolei Zhao


Yanhua, R.N. Chen


Aim: This study aimed to develop a diabetes mellitus educational material specifically for 10-19-year adolescents with type 1 diabetes mellitus (T1DM) based on the health belief model, and to develop webpages for adolescents to study the material.

Background: More than 1.11 million children and adolescents (<20 years) worldwide were diagnosed with T1DM in 2019, which has increased by approximately 3% every year in the last few decades. China is fourth for prevalence of adolescents with T1DM. Suboptimal diabetes management causes acute and chronic complications, as well as psychosocial disorders. However, adolescents do not achieve optimal diabetes management of T1DM. Education is the key to successful diabetes management, which could also maximise the effectiveness of diabetes treatment and the advances in diabetes management and technology. Nevertheless, limited diabetes education resources are available and tested scientifically in China. Existing diabetes materials are difficult for adolescents to read because of medical terms without appropriate explanation. In addition, there are no diabetes educational materials specifically for children or adolescents.

Methods: A feasibility testing study was conducted to test if the research design was feasible, including the development of the type 1 diabetes educational material, the development of the webpages, selection and translation of the outcome scales, and recruitment and retention of participants.

Results: 1) The type 1 diabetes educational material was developed for adolescents aged 10-19 years, translated and assessed to have good readability by adolescents and good content validity by experts; 2) The webpages were developed and assessed by participants to have good to excellent usability; 3) A type 1 diabetes knowledge scale (T1DK) with 12 items was developed for adolescents. Another three scales already validated included self-efficacy, adherence and webpage usability. The four scales were translated and tested with good readability in adolescents and content validity in experts. 4) In this feasibility study, 16 adolescents registered the webpages and six completed fully.

Conclusion: It is feasible to develop type 1 diabetes educational material with good readability and content validity in China. The webpages were rated as good to excellent with respect to usability. Outcome scales had good readability and content validity. However, there was low feasibility at the data collection stage because of the lower recruitment and retention rates. Four strategies will be implemented to improve the recruitment and retention rates in future: involvement of patients’ doctors or nurses; combination of several recruitment methods; regular and continuing contact with participants, and appropriate funding and incentives to participate.
In the future, a pilot with a large enough sample size will be conducted to test the new recruitment and retention strategies, and reliability and construct validity of the four scales. Subsequently, an effectiveness study will be conducted to test the effects of the web-based educational material on diabetes knowledge, self-efficacy and adherence among adolescents.


Zhao, X. (2020). Development and feasibility testing of a webpage-based diabetes education in adolescents with type 1 diabetes mellitus in China. (Thesis). University of Hull. Retrieved from

Thesis Type Thesis
Deposit Date Mar 11, 2021
Publicly Available Date Feb 23, 2023
Keywords Health & social work
Public URL
Additional Information School of Health and Social Work, The University of Hull
Award Date Jun 1, 2020


Thesis (14.5 Mb)

Copyright Statement
© 2020 Zhao, Xiaolei. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

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