Developing digital mental health tools for youth with diabetes: an agenda for future research

Youth living with diabetes face a concurrent challenge: managing a chronic health condition and managing the psychosocial and developmental changes that are characteristic of adolescence and young adulthood. Despite these unique challenges, psychological support is often difficult for youth with diabetes to access due to a lack of trained mental health professionals and other resource constraints. Digital wellbeing tools offer the potential to improve access to psychological support for this population. However, very few digital wellbeing tools exist for youth with diabetes. Of those that do exist, very few are evidence-based therapies, undermining their contribution to the field. Given the increasing global prevalence of diabetes in young people, the support necessitated by the challenges experienced by this population is not always accessible in a face-to-face setting and cannot be effectively scaled to meet demand. To support the health and wellbeing of youth with diabetes, there is a clear need to develop digital interventions that are widely accessible to users, but, more saliently, grounded in empirical evidence that supports their efficacy. Thus, the purpose of this paper is to offer an agenda for future research, including insights into which psychological techniques and behavioral change theories may be a good conceptual fit for digital mental health interventions, and how these tools may be best developed and utilized by the individuals that need them. Scalable, evidence-based wellbeing tools for this population are urgently required to improve psychological outcomes, and potentially, improve the equity of service access

[In Press] Intuitive Eating Scale-2 : psychometric properties and clinical norms among individuals seeking treatment for an eating disorder in private practice

Purpose Intuitive Eating (IE) is an approach to eating designed to facilitate a positive relationship with food. Its use in clinical settings and in the community is rapidly growing in popularity. The Intuitive Eating Scale 2 (IES-2) is a widely used measure that indexes intuitive eating motivations and behaviour, however evidence of its validity in populations with clinical eating disorders remains scarce. The objective of the proposed study was thus to evaluate the factor structure of the IES-2 in a large sample of individuals seeking treatment for eating disorders in private practice. Methods Data collected from 569 women and men aged 12–68 years seeking treatment for an eating disorder in one of eight specialist private outpatient eating disorder clinics were examined using confirmatory factor analysis (CFA). Relationships between IES-2 scores and measures of psychopathology were also examined. Results Results were relatively consistent with the purported four-factor structure of the IES-2. The measure displayed strong construct validity and good internal consistency. Scores on the IES-2 were inversely associated with scores of depression, anxiety, and disordered eating, providing evidence for divergent validity of the measure. Clinical norms are provided for anorexia nervosa (AN) spectrum disorders and bulimia nervosa (BN) spectrum disorders, as well as for the clinical sample as a whole. Conclusion Findings suggest that the IES-2 may be an appropriate measure for evaluating behaviours relating to IE in community outpatient eating disorder settings, and provide further evidence for the association between IE and positive health outcomes. Level of evidence III, evidence obtained from well-designed cohort or case–control analytic studies

Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations

To accelerate an end to diabetes stigma and discrimination an international multi-disciplinary expert panel (N=51 members, 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. They achieved Consensus on 25 Statements of Evidence and 24 Statements of Recommendations. The Consensus is that diabetes stigma is driven primarily by blame, perceptions of burden/sickness, (in)visibility, and fear/disgust. People with diabetes often encounter sigma (negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental and physical health, self-care, access to optimal healthcare, and social and professional opportunities. Up to one-in-three experience discrimination (unfair and prejudicial treatment) due to diabetes, e.g., in healthcare, education and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical and counterproductive. Collective leadership is needed to pro-actively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, the panel achieved unanimous consensus on a pledge to end diabetes stigma and discrimination