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Cited by 1Diabetes Management and EducationDiabetes Management and ResearchDigital Mental Health Interventions

Development and evaluation of the Flourish Diabetes Programme

Open access
Kruger, Sylvia, Deacon, Elmari, van Rensburg, Esme, Segal, David·2025·Health SA Gesondheid
DOI 10.4102/hsag.v30i0.2923PMC PMC12067628
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Abstract

Background: Adolescents with type 1 diabetes face unique challenges in adapting to closed-loop technology. Positive psychology interventions may aid in promoting psychological adjustment, enhancing well-being and supporting the effective use of this technology. Aim: This study describes the development, content and evaluation of a positive psychology intervention, the Flourish Diabetes Programme, to facilitate adjustment to closed-loop technology among adolescents with type 1 diabetes. Setting: The Flourish Diabetes Programme is an online, interactive intervention aimed at adolescents living with type 1 diabetes who use closed-loop technology. Methods: The development of the programme was informed by qualitative research with adolescents, qualitative document analysis and the design and development model. The Delphi method was used to evaluate the intervention, where 11 experts provided feedback to refine and enhance the programme. Results: Feedback from the Delphi panel informed the refinement and finalisation of the Flourish Diabetes Programme, contributing to an evidence-based and user-centred intervention. Conclusion: The Flourish Diabetes Programme is a tailored online resource designed to support adolescents in adapting to closed-loop technology. Insights from the Delphi panel helped shape the programme into a practical tool for promoting positive adjustment. Contribution: This intervention is the first step in developing effective, evidence-based resources to help adolescents with type 1 diabetes manage new medical technologies, specifically closed-loop systems, using positive psychological principles.

AI snapshot

Written from the paper’s full text.

TL;DR

This paper describes the development and expert evaluation of the Flourish Diabetes Programme, an online 7-week positive psychology intervention for adolescents aged 15–18 with type 1 diabetes using closed-loop technology. A two-round modified Delphi with 11 diabetes professionals produced seven themes that refined the programme’s content and structure, though the programme has not yet been pilot tested.

Key findings

  • Eleven diabetes professionals joined Delphi Round 1 and 10 continued in Round 2; their experience ranged from 6 to 35 years, and they included endocrinologists, general practitioners, diabetes educators, dietitians and psychologists.
  • Seven themes emerged and were incorporated into the final programme: helpful content for adjustment, caregiver and peer involvement, weekly feedback, identifying barriers at onset, technical feedback, recommendations regarding content, and duration of the programme.
  • The final Flourish Diabetes Programme is an online, interactive website for adolescents aged 15–18 using closed-loop technology; it runs for 7 weeks, includes three online facilitation sessions, weekly caregiver activities, a forum, badges as incentives, and PAID-T screening before and after the programme.
  • Expert feedback led to specific changes such as replacing “parent” with “caregiver,” changing “task” to “activity,” using mmol/L for the South African context, adding general diabetes guidelines and video content, and replacing collage making with social media-based activities.

Methods

  • Intervention development used Thomas and Rothman’s six-phase design and development model, informed by prior phenomenological research with adolescents using closed-loop technology, a qualitative document analysis, the PERMA model and the UTAUT.
  • A modified online Delphi technique was conducted over two rounds with 11 purposively and snowball-sampled diabetes professionals who had at least 2 years’ experience, worked with adolescents and were professionally registered.
  • Delphi data were analysed using Braun and Clarke’s thematic analysis; trustworthiness was supported by referencing raw data, verbatim extracts, a reflective journal, a co-coder and the lead researcher’s psychology training.

Limitations

  • The paper states that the programme has not been pilot tested and recommends pilot testing to assess uptake, feasibility and effectiveness.
  • The paper states that only one mental health expert participated in the Delphi study and recommends obtaining further feedback from mental health experts.
  • The paper states that adolescent motivation should be considered and that some participants may not complete the full 7 weeks; evident from the text, the evaluation relies on expert consensus rather than adolescent user testing or quantitative outcomes such as time in range or HbA1c.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.4102/hsag.v30i0.2923

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 43 cited sources checked · 0 supported · 0 flagged

  • Findingreasoning

    The perspectives of the professionals assisted the researchers in refining the intervention programme.

    “The perspectives of the professionals assisted the researchers in refining the intervention programme.”
    Quote in the paperSubstantial claim
  • Findingown data

    Experts found the Flourish Diabetes Programme valuable for adolescent adjustment to closed-loop technology and diabetes identity.

    “Experts found the intervention valuable for adolescent adjustment to closed-loop technology and diabetes identity.”
    Quote in the paperSubstantial claim
  • Findingown data

    All experts viewed support from caregivers, peer group, and weekly feedback as beneficial.

    “All the experts viewed the support from caregivers, the support from the peer group and the weekly feedback as beneficial.”
    Quote in the paperNot a substantial claim
  • Interpretationnone given

    Insights from the Delphi panel helped shape the programme into a practical tool for promoting positive adjustment.

    “Insights from the Delphi panel helped shape the programme into a practical tool for promoting positive adjustment.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: No positive psychology intervention has specifically focused on adolescents with type 1 diabetes adjusting to closed-loop technology.
  • Premisecitation

    There is a notable inconsistency in the adoption and utilisation of diabetes technology among adolescents compared to younger children and adults.

    “yet there exists a notable inconsistency in the adoption and utilisation of diabetes technology within this age group when compared to younger children and adults.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Pals et al. 2021

      Not checked in the free run.

  • May combine two claims. 26
  • Classified as probably not a substantial claim. 48

  • May combine two claims.

    Findingnone given

    Feedback from the Delphi panel informed the refinement and finalisation of the Flourish Diabetes Programme, contributing to an evidence-based and user-centred intervention.

    “Feedback from the Delphi panel informed the refinement and finalisation of the Flourish Diabetes Programme, contributing to an evidence-based and user-centred intervention.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: No positive psychology intervention has specifically focused on adolescents with type 1 diabetes adjusting to closed-loop technology.

  • May combine two claims.

    Findingreasoning

    The Flourish Diabetes Programme is an online, interactive, tailored resource for adolescents with type 1 diabetes who use closed-loop technology, designed to support their adaptation to the technology.

    “The Flourish Diabetes Programme is an online, interactive intervention aimed at adolescents living with type 1 diabetes who use closed-loop technology.”
    • Also stated in: § Conclusion · plain
      “The Flourish Diabetes Programme is a tailored online resource designed to support adolescents in adapting to closed-loop technology.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: No positive psychology intervention has specifically focused on adolescents with type 1 diabetes adjusting to closed-loop technology.

  • May combine two claims.

    Findingown data

    Seven themes emerged from the Delphi panel and were incorporated into refining the intervention programme.

    “Seven themes emerged and were incorporated into refining the intervention programme.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Experts recommended the inclusion of video content.

    “Regarding the content, the experts recommended the inclusion of more general information on diabetes, as well as video content, to make the programme more suitable for the developmental level of adolescents and to ensure that the amount of time needed to engage in the programme on a weekly basis was not too much.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    Considering adolescents' developmental needs, during this phase there is an increased need for independence, with some parental support.

    “It was highlighted that, considering adolescents’ developmental needs, during this phase, there is an increased need for independence, with some parental support.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Sophy suggested that adolescents should attend the programme with adolescents using the same diabetes technology.

    “Sophy (registered nurse and diabetes educator) also suggested that adolescents should attend the programme with adolescents who are using the same diabetes technology in order for the adolescents to relate to one another and avoid confusion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most experts found the programme duration adequate.

    “Most experts found the programme duration adequate, though Jack (paediatric endocrinologist) worried it might be too time intensive.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    Experts identified a gap in emotional support in diabetes training.

    “Mia and Emma noted a gap in emotional support in diabetes training, with trust, motivation and positive goal setting identified as key for adjustment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Experts recommended the inclusion of more general information on diabetes.

    “Regarding the content, the experts recommended the inclusion of more general information on diabetes, as well as video content, to make the programme more suitable for the developmental level of adolescents and to ensure that the amount of time needed to engage in the programme on a weekly basis was not too much.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All experts viewed weekly feedback as beneficial and a means of maintaining engagement.

    “All the experts viewed the weekly feedback as beneficial and a means of maintaining engagement with the intervention.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    Experts identified gaps in the educational content.

    “Experts identified gaps in the educational content.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Experts recommended technical adjustments and using language in a sensitive manner.

    “Recommended adjustments included technical aspects and using language in a sensitive manner.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Experts agreed the intervention would benefit a wider diabetes population.

    “Emma and Hannah agreed the intervention would benefit a wider diabetes population.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    Trust, motivation and positive goal setting are key for adjustment.

    “Mia and Emma noted a gap in emotional support in diabetes training, with trust, motivation and positive goal setting identified as key for adjustment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Jack worried the programme might be too time intensive.

    “Most experts found the programme duration adequate, though Jack (paediatric endocrinologist) worried it might be too time intensive.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    All experts were of the opinion that the amount of caregiver involvement was adequate and would give adolescents a sense of autonomy.

    “All the experts were of the opinion that the amount of involvement from caregivers within the intervention was adequate and would give the adolescents a sense of autonomy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Hannah noted the tasks were concise and manageable.

    “Hannah (dietitian) noted the tasks were concise and manageable.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The weekly feedback was appropriate in terms of the amount of time required by adolescents to provide feedback.

    “It was emphasised that the weekly feedback was appropriate in terms of the amount of time required by the adolescents to provide feedback.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Findingnone given

    The experts were of the opinion that the proposed intervention programme would assist adolescents in their adjustment to closed-loop technology.

    “The experts were of the opinion that the proposed intervention programme would assist adolescents in their adjustment to closed-loop technology.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Samuel identified diabetes distress as a potential barrier to engagement and suggested including a screening tool prior to participation.

    “Samuel (psychologist) identified diabetes distress as a potential barrier to engagement with the intervention and suggested including a screening tool prior to participation in order to address any potential barriers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Experts emphasised the importance of engaging with other adolescents to have a sense of connection and support.

    “The experts emphasised the importance of engaging with other adolescents to have a sense of connection and support and possibly providing practical support to one another.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Positive psychology interventions may aid in promoting psychological adjustment, enhancing well-being and supporting the effective use of closed-loop technology.

    “Positive psychology interventions may aid in promoting psychological adjustment, enhancing well-being and supporting the effective use of this technology.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Hilliard, Powell and Anderson 2016

      Not checked in the free run.

    • cites Pressman & Cohen 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Closed-loop technology automates some aspects of diabetes management, but meal boluses still require manual administration.

    “While the system automates some aspects of diabetes management, meal boluses still require manual administration (Forlenza, Buckingham & Maahs 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Forlenza, Buckingham & Maahs 2016

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    This intervention is the first step in developing effective, evidence-based resources to help adolescents with type 1 diabetes manage new medical technologies, specifically closed-loop systems, using positive psychological principles.

    “This intervention is the first step in developing effective, evidence-based resources to help adolescents with type 1 diabetes manage new medical technologies, specifically closed-loop systems, using positive psychological principles.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: No positive psychology intervention has specifically focused on adolescents with type 1 diabetes adjusting to closed-loop technology.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    It is crucial that psychosocial factors are addressed and improved to increase the acceptance of closed-loop systems.

    “When psychological barriers are considered, it is crucial that psychosocial factors are addressed and improved to increase the acceptance of closed-loop systems (Barnard et al. 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Barnard et al. 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Closed-loop systems can improve HbA1c and reduce hyperglycaemia.

    “Medically, closed-loop systems can improve one’s HbA1c (haemoglobin A1c) and reduce hyperglycaemia (Beato-Víbora et al. 2021; Tauschmann et al. 2019).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Beato-Víbora et al. 2021

      Not checked in the free run.

    • cites Tauschmann et al. 2019

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Emotional well-being improves with the amount of time spent in the target blood glucose range.

    “it has been found that emotional well-being improves with the amount of time spent in the target blood glucose range (time in range) (Rabbone et al. 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rabbone et al. 2022

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Utilising diabetes technology to its full potential requires education on the closed-loop system.

    “Utilising diabetes technology to its full potential also requires education on the closed-loop system (Rabbone et al. 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rabbone et al. 2022

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Improvement in diabetes-specific emotional distress is associated with the use of diabetes technology.

    “improvement in diabetes-specific emotional distress is associated with the use of diabetes technology (Vesco et al. 2018)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Vesco et al. 2018

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Managing diabetes as an adolescent involves a complex interaction of medical, behavioural and social changes, where psychological functioning is a crucial component.

    “Managing diabetes as an adolescent involves a complex interaction of medical, behavioural and social changes, where psychological functioning is a crucial component (Gonzalez, Tanenbaum & Commissariat 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gonzalez, Tanenbaum & Commissariat 2016

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Limited studies have investigated the psychological impact of diabetes technology, and little is known about the psychological factors that improve the usage of diabetes technology.

    “Limited studies have investigated the psychological impact of diabetes technology, for example the impact thereof on people’s well-being or quality of life (Weissberg-Benchell, Antisdel-Lomaglio & Seshadri 2003), and little is known about the psychological factors that improve the usage of diabetes technology (Borges & Kubiak 2016).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Weissberg-Benchell, Antisdel-Lomaglio & Seshadri 2003

      Not checked in the free run.

    • cites Borges & Kubiak 2016

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The study included a diverse group of experts - endocrinologists, general practitioners, diabetes educators, dietitians and psychologists - ensuring heterogeneity.

    “This study included a diverse group of experts – endocrinologists, general practitioners, diabetes educators, dietitians and psychologists – ensuring heterogeneity (Keeney et al. 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Keeney et al. 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Eleven experts joined Round 1, and 10 continued in Round 2 because of one expert's withdrawal.

    “Eleven experts joined Round 1, and 10 continued in Round 2 because of one expert’s withdrawal.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The thematic analysis continued until the research question had been answered and no new themes emerged.

    “The thematic analysis continued until the research question had been answered and no new themes emerged (Willig 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Willig 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study adhered to the Protection of Personal Information Act (POPIA) to ensure confidentiality and secure handling of participant data.

    “This study adhered to the Protection of Personal Information Act (POPIA) to ensure confidentiality and secure handling of participant data.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The researchers ensured theme validity by continuously referencing raw data, using verbatim extracts and maintaining a reflective journal to minimise bias.

    “The researchers ensured theme validity by continuously referencing raw data, using verbatim extracts and maintaining a reflective journal to minimise bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Anonymity was ensured to encourage open and diverse opinions.

    “Anonymity was ensured to encourage open and diverse opinions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    A co-coder verified interpretations, and verbatim quotations supported findings.

    “A co-coder verified interpretations, and verbatim quotations supported findings.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    In optimal human functioning and fulfilment, flourishing is achieved as a result of the components of the PERMA model.

    “Seligman (2011) argues that in optimal human functioning and fulfilment, and as a result of the components of the PERMA model, flourishing is achieved.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Seligman 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The number of Delphi rounds depended on achieving consensus.

    “The number of rounds depended on achieving consensus (Hsu & Sandford 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hsu & Sandford 2007

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    UTAUT is relevant in the context of adjustment to closed-loop technology and emphasises the important role of individual beliefs, attitudes and perceptions in making decisions in healthcare and using technology.

    “This theory is relevant in the context of adjustment to closed-loop technology and emphasises the important role of the individual’s beliefs, attitudes and perceptions in making decisions in healthcare and using technology (Venkatesh & Davis 2000).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Venkatesh & Davis 2000

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Positive psychology interventions in type 1 diabetes can be beneficial by focusing on the strengths of adolescents and their families to promote resilience.

    “Hilliard, Powell and Anderson (2016) argue that an emphasis on positive psychology interventions in type 1 diabetes (e.g. Jaser et al. 2014) can be beneficial, as such interventions would focus on the strengths of the adolescents and their families to promote resilience.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hilliard, Powell and Anderson 2016

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the Health Research Ethics Committee (HREC) of the North-West University, South Africa (reference no.: NWU-00266-21-A1).

    “The study was approved by the Health Research Ethics Committee (HREC) of the North-West University, South Africa (reference no.: NWU-00266-21-A1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductnone given

    The lead researcher, a trained psychologist, ensured accurate analysis.

    “The lead researcher, a trained psychologist, ensured accurate analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    In Round 2, experts received a summary of anonymised responses to encourage honest input.

    “In Round 2, experts received a summary of anonymised responses to encourage honest input (Keeney et al. 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Keeney et al. 2011

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The Delphi method is useful in health care, especially in the development of guidelines and the identification of key constructs of interventions.

    “The Delphi method is a consensus technique (Trevelyan & Robinson 2015) that is useful in the context of health care (Keeney, Hasson & Mckenna 2011), especially in the development of guidelines and the identification of key constructs of interventions (Lai et al. 2015; Ward et al. 2014).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Keeney, Hasson & Mckenna 2011

      Not checked in the free run.

    • cites Lai et al. 2015

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    • cites Ward et al. 2014

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  • May combine two claims.

    Premisecitation

    Themes identified in the authors' prior phenomenological study and qualitative document analysis were the importance of knowledge and diabetes education, the process of positive adjustment to closed-loop technology, a positive outlook and building a relationship with diabetes.

    “The identified themes were the importance of knowledge and diabetes education, the process of positive adjustment to closed-loop technology, a positive outlook and building a relationship with diabetes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kruger et al. 2023, 2024

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    According to the UTAUT model, effort expectancy, performance expectancy, social influence and facilitating conditions are the most important factors of behavioural intention.

    “According to the UTAUT model, effort expectancy, performance expectancy, social influence and facilitating conditions are the most important factors of behavioural intention (Venkatesh et al. 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Venkatesh et al. 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Informed consent was obtained both verbally and in writing from all participants.

    “Informed consent was obtained both verbally and in writing from all participants.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The Delphi method is a consensus technique.

    “The Delphi method is a consensus technique (Trevelyan & Robinson 2015)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Trevelyan & Robinson 2015

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Participants were required to have at least 2 years' experience, work with adolescents and be professionally registered.

    “Participants needed at least 2 years’ experience, work with adolescents and be professionally registered.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The different fields of diabetes in which the experts work assisted the researchers in gaining a broad understanding of adolescents' adjustment to closed-loop technology and refining the programme to provide a holistic programme for adolescents.

    “The different fields of diabetes in which the experts work assisted the researchers in gaining a broad understanding of adolescents’ adjustment to closed-loop technology and refining the programme to provide a holistic programme for adolescents.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Circle of Control activity shifts focus to controllable factors and avoids fixation on external challenges.

    “Participants also complete the Circle of Control activity (Covey 2020) to shift focus to controllable factors, avoiding fixation on external challenges.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Covey 2020

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    SMART goal setting promotes autonomy and accountability.

    “Week 3 focusses on positive goal setting using SMART goals (specific, measurable, attainable, relevant and time-bound) to promote autonomy and accountability (Nguyen-Vaselaar & Lappe 2021).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nguyen-Vaselaar & Lappe 2021

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Adolescence is a critical developmental stage.

    “aligning with the critical developmental stage of adolescence (Chiang et al. 2014).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Chiang et al. 2014

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Within the intervention, it will be beneficial for adolescents of the same age group to learn from one another.

    “Consequently, within the intervention, it will be beneficial for adolescents of the same age group to learn from one another.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Adolescents of different ages navigate different challenges, developmental tasks and changes on their journey with diabetes.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Obtaining feedback from experts in various fields of diabetes was beneficial for refining the intervention programme in a holistic manner.

    “Obtaining feedback from experts in various fields of diabetes was beneficial, as the researchers could draw from their diverse opinions and backgrounds. Thus, it assisted with the refinement of the intervention programme in a holistic manner.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The proposed intervention programme is grounded in empirical data - a literature review - and the principles of positive psychology.

    “Although the proposed intervention programme is grounded in empirical data – a literature review – and the principles of positive psychology and has been evaluated by a panel of experts, the programme has not been pilot tested.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Delivering the intervention through a free website makes it more accessible to participants.

    “Technological advances are leveraged in this programme as the intervention content will be delivered through a free website, making it more accessible to participants.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The 'best possible self' activity helps envision a positive future.

    “Participants engage in a ‘best possible self’ activity (Sheldon & Lyubomirsky 2006) to envision a positive future, setting health behaviour goals and identifying steps towards achieving them.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sheldon & Lyubomirsky 2006

      Not checked in the free run.

60 of 60

  • The paper relies on this without support.

    No positive psychology intervention has specifically focused on adolescents with type 1 diabetes adjusting to closed-loop technology.

    “With regard to adolescents living with type 1 diabetes, no positive psychology intervention has specifically focussed on their adjustment to closed-loop technology although various research studies have explored interventions in the context of health and positive psychology (i.e. Charlson et al. 2007; Jaser et al. 2020; Ogedegbe et al. 2012; Peterson et al. 2012).”

  • The paper relies on this without support.

    Achieving expert consensus on the key components of the intervention improves engagement with the technology.

    “It was used to achieve expert consensus on the key components of the intervention in order to improve engagement with the technology.”

  • The paper relies on this without support.

    The themes identified in the authors' prior studies are essential constructs for the intervention programme.

    “In the phenomenological study and the qualitative document analysis, themes were identified to identify essential constructs of the intervention programme.”

  • The paper relies on this without support.

    Adolescents of different ages navigate different challenges, developmental tasks and changes on their journey with diabetes.

    “This age group was chosen because adolescents of different ages navigate different challenges, developmental tasks and changes on their journey with diabetes.”

  • The paper relies on this without support.

    Psychological barriers, including diabetes-related stigma, anxiety about technology dependence and concerns over device visibility, significantly impact engagement with closed-loop systems.

    “Psychological barriers, including diabetes-related stigma, anxiety about technology dependence and concerns over device visibility, significantly impact engagement with closed-loop systems.”

  • The paper relies on this without support.

    Gratitude journaling reflections foster emotional resilience and build a habit of noticing the good amidst the difficulties of managing type 1 diabetes.

    “These reflections foster emotional resilience and build a habit of noticing the good amidst the difficulties of managing type 1 diabetes.”

  • The paper relies on this without support.

    Reading about interpreting glucose data fosters a constructive mindset towards diabetes management.

    “This reading fosters a constructive mindset towards diabetes management.”

  • The paper relies on this without support.

    Sharing one new fact about type 1 diabetes daily promotes shared learning, empathy, and stronger communication within families.

    “In addition, adolescents and their caregivers are invited to share one new fact about type 1 diabetes with each other daily, promoting shared learning, empathy, and stronger communication within families.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Current approaches to studying T2DM behaviors include quantitative surveys, qualitative interviews, and emerging digital health technologies, each with distinct advantages and limitations.

    “Current approaches include quantitative surveys, qualitative interviews, and emerging digital health technologies, each offering distinct advantages and limitations [5].”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [5]

    The Introduction discusses benefits and barriers of diabetes technology, and Research methods and design describes interviews and an open-ended questionnaire. But these passages concern adolescents with type 1 diabetes and the development of an intervention; they do not present a comparison of approaches to studying type 2 diabetes behaviours or the distinct advantages and limitations of surveys, interviews, and digital health technologies. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. De Vos, A.S. & Strydom, H., 2011, ‘Intervention research’, in A.S. de Vos, H. Strydom, C.B. Fouche & C.S.L. Delport (eds.), Research at grass roots for social science and human service professions, 4th edn., pp. 473–489, Van Schaik, Pretoria.
  2. Thomas, E.J. & Rothman, J., 1994, Intervention research: Design and development for human service, Haworth Press, New York, NY.
  3. Willig, C., 2013, Introducing qualitative research in psychology, McGraw-Hill, Maidenhead.

Cited by

Sorted by citations

Related

Authors
Kruger, S., Deacon, E., van Rensburg, E., & Segal, D.
Affiliations
  • North-West University (ZA)
  • North-West University
Corresponding author
Kruger, Sylvia
ORCID
Venue
Health SA Gesondheid
Publisher
AOSIS
Published
2025-04-04
Volume
30
Issue
0
Pages
2923-2923
ISSN
  • 1025-9848 (ISSN-L)
  • 2071-9736
DOI
10.4102/hsag.v30i0.2923
PMC
PMC12067628
OpenAlex
W4409172884
Semantic Scholar
994d0bf5e6f870a3fb09bb198990f07cbac844f5
Cited by
1
References
53
Citations by year
2025: 1
FWCI
0.68
Type
journal article
Language
en
Open access
Licence
Locations
  • Health SA Gesondheid (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
North-West University
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
type 1 diabetes, adolescents, insulin pump, positive psychology interventions, online intervention, psychological adjustment, well-being, Delphi panel

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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