Summary
Children and young people with type 1 diabetes (T1D) can find school and college difficult to manage and can suffer from mental health problems due to staff and teachers’ lack of support and knowledge. Working with the NHS Leicester Royal Infirmary children’s research and diabetes teams, HEAL.med CIC created an e-learning portal, called Educate Diabetes, to deliver effective training to school staff. The programme can be accessed by all primary and secondary schools across Leicester, Leicestershire and Rutland.
Innovation
Children have been sent home from school because teachers did not know what to do when their glucose was not in range and reprimanded for beeping or noises created by technology, such as pumps and scanners. They have also hidden their diabetes from teachers out of shame. Children feel stigmatised and embarrassed because of a lack of staff education and support. There is also an impact on parents, who are called to the school/college to look after their child. Working with the NHS Leicester Royal Infirmary Children’s research and diabetes teams, HEAL.med CIC created an e-learning portal to deliver effective training to school staff. Since the pilot started in August 2023, over 1,000 staff have successfully completed the programme. The website/e-learning platform hosts bespoke training, comprising 10 modules, 60 video slides with a narrated voiceover, plus a light-touch multiple-choice question at the end of each section. Once a user completes the e-learning, they are invited to join an interactive webinar with the Leicester School Diabetes Team. This utilises flipped learning methods to give school staff the knowledge to engage in the session. Mentimeter, an interactive quiz platform, allows participants to answer questions remotely and in a more engaging way. Finally a short quiz automatically provides a certificate to users. The information is aimed at those who have no, or little, diabetes knowledge, helping them to feel comfortable dealing with a child or young person with T1D in school. Access is 24/7, allowing school staff to refresh their knowledge at any point. The aim is to roll out the training programme to the wider diabetes community across the UK, using a phased approach, starting with two additional NHS trusts. The content will be changed to meet the needs of each local education authority. Practical training will be provided on how to use the system, with ongoing technical support. It will be updated yearly to meet international guidelines.
Equality, Diversity and Variation
A quarter of adolescents with diabetes experience depression (greater than twice the general population). ‘Diabetes burnout’ is a common mental health issue with people with T1D, where they no longer manage their diabetes sufficiently due to stress, environmental reasons, poor support and stigma as a result of not feeling ‘normal’. The hope is that the staff training will help them recognise these symptoms and help the students feel less isolated and different. Students will be able to participate more in after-school activities and trips, without feeling they are a burden, which many students have reported. Educate Diabetes has increased the amount of teachers and other members of staff attending diabetes education by delivering training directly to them. Ensuring staff have a better understanding of T1D will help avoid public confrontation between staff and pupils and remove misconceptions before incidents occur that would impact a pupil’s mental health. It has helped create a more inclusive and supportive environment that acknowledges and accommodates their specific needs. The video content (from the diabetes education app, Deapp) used in this programme is also available in other languages.
Results
This intervention aims to create better understanding of T1D in schools and a more empathetic environment for children and young people with T1D. Previously, the training was a three-hour online PowerPoint presentation and teachers would sign up and then not attend or switch off before it had finished. Gaps in knowledge were not being addressed and it was not engaging. Now the training time is significantly reduced to two, one-hour sessions. Staff responded positively to the Educate Diabetes pilot, particularly favouring the reduced training time and flexible opportunities to complete it. To date, 1,006 staff have attended an engage session with a member of the diabetes team and teachers have logged on to the website 3,137 times. Based on 453 responses via evaluations or feedback, 62% said they had never had any diabetes training before, 51% scored the usefulness of the session 10/10, 44 % scored the engagement of the content 10/10, plus 45% gave 10/10 when asked if they felt more confident about T1D than they had before. The online booking system has meant that the hospital diabetes team does not need to handle emails or queries from schools, reducing administrative time to 0.5 hours – a decrease of 98.78% – and costs. Educate Diabetes is supported by Diabetes UK, the National Institute for Health and Care Research and Leicester Education Authority.
User Feedback
There has been lots of positive feedback for this new system, which has reduced the diabetes team’s workload immensely so staff can concentrate on patient care. Teachers’ feedback has led to further improvements, such as adding more content and providing more instructions on how to use Mentimeter, sign up to a session, take the quiz and download certificates.
Dissemination and Sustainability
Educate Diabetes will be offered across the UK, starting with two more NHS trusts, then expanded further once the functionality and capacity of the system has been tested. The content will be changed to meet the needs of each local education authority to incorporate any differences in practice. Practical training will be provided on how to use the system and ongoing technical support will be available. The programme will be updated yearly to meet international guidelines. Educate Diabetes has been used in Leicester, Leicestershire and Rutland schools, covering approximately 270 primary schools with 5,021 teachers serving 89,100 students. There are 114 secondary schools that serve 72,348 students. Plans include recruiting a project manager for the rollout, tailored programme updates to support an increased number of education authorities and staff, plus keeping content current.
