Type 1 and type 2 diabetes are associated with long-term complications, especially among children. In particular, the management of type 1 diabetes is complex and demands specific knowledge and understanding of the invasive procedures associated with it. After the diagnosis of type 1 diabetes, schoolchildren are expected to make changes in their routine and develop self-care behavior. Apart from children, parents, teachers, and other school staff are expected to be knowledgeable about the management of type 1 diabetes. However, statistics indicate that children sometimes do not receive proper care in schools because of the lack of proper school staff support or availability of nurses. Consistently, the study by Bechara et al. (2018) recognized the school as a critical environment for the management of diabetes for children. Based on a qualitative study with a descriptive design, the authors sought to examine the effectiveness of an education intervention in promoting a safe school environment and supporting children with type 1 diabetes.
The KiDs and Diabetes in Schools is a global program designed to improve the quality of support children with diabetes get in schools. The objective of the study was aimed at evaluating the effectiveness of the KiDs program in promoting a safe school environment and providing support to children with type 1 diabetes. In particular, the intervention was designed to help with the management of diabetes, eliminate discrimination, increase diabetes awareness, and improve the awareness of the benefits of healthy eating habits and physical exercise among children. The study also targeted teachers and other professionals as part of an effort to control obesity and overweight in children, which is a major risk factor for diabetes. The qualitative-descriptive study targeted 15 schools – 7 private and 9 public schools in Sao Paulo and Fortaleza. Out of the number of schools targeted, 5 primary schools – 2 private and 3 public were randomly picked to conduct the evaluation of the program. 42 people were interviewed twice at one month and three months after the intervention. The target group was evaluated regarding the improvement of knowledge in diabetes and maintenance of health, impact, responsibilities, caring for children with diabetes, children behavior in school, lifestyle changes, and satisfaction with the program. Data analysis of the data collected in interviews was submitted for content analysis and revealed the following results presented based on different categories.
The first category was the knowledge of diabetes treatment. Before the intervention, professionals were not confident about dealing with children with diabetes. They also admitted that school staffs were only exposed to diabetes management after a student in the school was diagnosed with the condition. Parents also expressed frustration and lack of support from the school professionals. However, after the intervention, perceptions changed and school professionals had increased knowledge and information on diabetes management. Parents also expressed increased confidence in the ability of school professionals to take care of their diabetic children.
The second category was the responsibilities and behavior of school professionals concerning diabetes and healthcare. Before the intervention, school staff was reluctant to help with insulin doses, injection, and finger pricks. There was also a knowledge gap on what is needed in case of an emergency. After the intervention, the school professionals were more available to help students with diabetes.
The third category was the perception of the KiDS educational intervention. Participants acknowledged that the program was enlightening and enriching. Parents of children with diabetes expressed their happiness in the educational intervention. The information also helped changed the relationship between diabetic children, the school professionals, and their classmates.
The fourth category was support in the school environment and measures expected from schools. Ideally, some of the support measures provided to children with diabetes included the ability to respond appropriately in case of hypoglycemia, showing affection to children with diabetes, and not discriminating against children with diabetes among others. After the intervention, results indicated that school professionals indicated that they were knowledgeable about dealing with diabetes.
The fifth category focused on the impact of the educational intervention on the school environment. After the intervention, there was increased healthy habits and a calmer environment when children with diabetes were having meals. School professionals were more willing to help children with diabetes.
The last category was suggestions from the target groups. School staff and parents made various recommendations on ways to improve the management of diabetes among children. The school staff suggested working with parents to understand the management of diabetes for their children. Other suggestions included distribution of printed material to help with the educational intervention, emphasized the need for healthcare providers in schools, and the need to train school staff in diabetes management among others.
Evidently, type 1 diabetes is among the most complex conditions in schools. Management of T1D involves the collaboration of parents, children, teachers, and school staff. The study sought to examine the effectiveness of educational interventions in creating a safe environment for children and helping with the management of diabetes. The KiDS Program was successful in fostering a safe and supportive environment and increasing knowledge about diabetes treatment for schoolchildren.
Bechara, G. M., Castelo, B. F., Rodrigues, A. L., Chinnici, D., Chaney, D., Calliari, L. E. P., & Franco, D. R. (2018). “KiDS and Diabetes in Schools” project: Experience with an international educational intervention among parents and school professionals. Pediatric Diabetes, 19(4), 756-760.
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