- •A CST-US program was adapted for youth with T1D in China through a multi-phase process, and guided by a heuristic framework.
- •The adapted program is culturally relevant, acceptable to stakeholders, and aligned with the healthcare system in China.
- •Youth had a high attendance at the sessions, and reported high satisfaction with the program.
To adapt an evidence-based coping skills training program to the cultural context and healthcare system for youth with T1D in China, and to evaluate the feasibility, acceptability, and preliminary efficacy of the modified program.
Design and methods
A multiphase process was used based on a heuristic framework for program modification. This included information gathering, preliminary adaptation, and feasibility evaluation.
In Stage 1, the coping skills training protocol was translated and evaluated for relevance by the stakeholders (youth diagnosed with T1D, parents, and healthcare providers). Recommendations for revisions and culturally relevant scenarios were identified. In Stage 2, the program was adapted for youth with a wider age range. Scenarios and logistics of the program were changed, and a session on blood glucose management was added to enhance cultural relevance. In Stage 3, the feasibility of the modified program was evaluated with 15 youth participants diagnosed with T1D (mean age: 13.88 years). Problem-solving coping and the self-efficacy of the youth improved over time (p < .05). High attendance, engagement, and satisfaction were achieved.
The CST-China program has the potential to provide Chinese youth with T1D an interactive and engaging program to improve health outcomes. The adaptation process of a CST program can provide a reference for pediatric nurses to develop programs which are culturally relevant, acceptable to stakeholders, and aligned with the healthcare system in China.
A coping skills training program was systematically adapted and aligned to the healthcare system in China, with evidence of feasibility and acceptability in Chinese youth with T1D.
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- A heuristic framework for the cultural adaptation of interventions.Clinical Psychology: Science and Practice. 2006; 13: 311-316https://doi.org/10.1111/j.1468-2850.2006.00043.x
- Cultural adaptations of behavioral health interventions: A progress report.Journal of Consulting and Clinical Psychology. 2013; 81: 196-205https://doi.org/10.1037/a0027085
- The importance of glycemic control: How low should we go with HbA1c? Start early, go safe, go low.Journal of Diabetes and its Complications. 2011; 25: 202-207https://doi.org/10.1016/j.jdiacomp
- The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit.Prevention Science. 2004; 5: 41https://doi.org/10.1023/b:prev.0000013980.12412.cd
- Issues and challenges in the design of culturally adapted evidence-based interventions.Annual Review of Clinical Psychology. 2010; 6: 213https://doi.org/10.1146/annurev-clinpsy-033109-132032
- Who has more opportunities to attend college?-an empirical study of the strata distribution of different qualities of higher education opportunities in China.Chinese Education & Society. 2015; 48: 201-217https://doi.org/10.1080/10611932.2015.1085769
- Guidelines for diagnosis and treatment of type 1 diabetes in China.Diabetes World (Clinical). 2013; 7: 152-154https://doi.org/10.3969/j.issn.1672-7851.2013.03.002
- IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045.Diabetes Research and Clinical Practice. 2018; 138: 271-281https://doi.org/10.1016/j.diabres.2018.02.023
- Teaching teens to cope: Coping skills training for adolescents with insulin-dependent diabetes mellitus.Journal of the Society of Pediatric Nurses. 1997; 2: 65-72https://doi.org/10.1111/j.1744-6155.1997.tb00062.x
- Stressors and self-care challenges faced by adolescents living with type 1 diabetes.Applied Nursing Research. 2004; 17: 72-80https://doi.org/10.1016/j.apnr.2004.02.006
- Culture and diet among Chinese American children aged 9-13 years: A qualitative study.Journal of Nutrition Education and Behavior. 2016; 49: 275-284https://doi.org/10.1016/j.jneb.2016.11.002
- An analysis of the relationships between peer support and diabetes outcomes in adolescents with type 1 diabetes.Journal of Health Psychology. 2018; 23: 1356-1366https://doi.org/10.1177/1359105316656228
- The effect of coping skills training on depression, anxiety, stress, and self-efficacy in adolescents with diabetes: A randomized controlled trial.International Journal of Community Based Nursing and Midwifery. 2018; 6 (Retrieved from): 324-333
- Power distance in the Chinese and American family—A comparative study based on parent-child relation.Folk Art and Literature. 2011; (Retrieved from): 8-24
- Metabolic control as reflected by HbA1c in children, adolescents and young adults with type-1 diabetes mellitus: Combined longitudinal analysis including 27, 035 patients from 207 centers in Germany and Austria during the last decade.European Journal of Pediatrics. 2008; 167: 447-453https://doi.org/10.1007/s00431-007-0586-9
- Coping skills training for youth with diabetes mellitus has long-lasting effects on metabolic control and quality of life.The Journal of Pediatrics. 2000; 137: 107-113https://doi.org/10.1067/mpd.2000.106568
- Coping skills training for youths with diabetes on intensive therapy.Applied Nursing Research. 1999; 12: 3-12https://doi.org/10.1016/s0897-1897(99)80123-2
- The contribution of coping behaviors at diagnosis to adjustment one year post diagnosis in children with diabetes.Nursing Research. 1997; 46: 312-317https://doi.org/10.1111/j.1744-6155.1997.tb00062.x
- Coping skills training for parents of children with type 1 diabetes: 12-month outcomes.Nursing Research. 2011; 60: 173-181https://doi.org/10.1097/NNR.0b013e3182159c8f
- Effects of coping skills training in school-age children with type 1 diabetes.Research in Nursing & Health. 2009; 32: 405-418https://doi.org/10.1002/nur.20336
- Improving mental health of adolescents with type 1 diabetes: Protocol for a randomized controlled trial of the nothing ventured nothing gained online adolescent and parenting support intervention.BMC Public Health. 2013; 13: 1185https://doi.org/10.1186/1471-2458-13-1185
- Revision of coping style scale for adolescents.Chinese Journal of Clinical Psychology. 2006; 14: 566-568https://doi.org/10.3969/j.issn.1005-3611.2006.06.005
- The construction of a harmonious doctor-patient relationship based on the “summer campus for children with diabetes”.Modern Hospital Management. 2008; 22: 10-12https://doi.org/10.3969/j.issn.1672-4232.2008.01.005
- The effect of psychological and behavioral intervention and its influencing factors among type 2 diabetes patients.(Doctoral dissertation) Fujian Medical University, 2016 (Retrieved from)
- Cultural adaptation of preschool PATHS (Promoting Alternative Thinking Strategies) curriculum for Pakistani children.International Journal of Psychology. 2014; 50: 232https://doi.org/10.1002/ijop.12090
- Stress and coping predicts adjustment and glycemic control in adolescents with type 1 diabetes.Annals of Behavioral Medicine. 2017; 51: 30-38https://doi.org/10.1007/s12160-016-9825-5
- Psychosocial problems in adolescents with type 1 diabetes mellitus.Diabetes & Metabolism. 2009; 35: 339-350https://doi.org/10.1016/j.diabet.2009.05.002
- Effects on stress reduction of a modified mindfulness-based cognitive therapy for family caregivers of those with dementia: Study protocol for a randomized controlled trial.Trials. 2019; 20: 303https://doi.org/10.1186/s13063-019-3432-2
- Effects of a modified mindfulness-based cognitive therapy for family caregivers of people with dementia: A pilot randomized controlled trial.International Journal of Nursing Studies. 2019; 98: 107-117https://doi.org/10.1016/j.ijnurstu.2019.02.020
- A systematic review of health promotion and disease prevention program adaptations: How are programs adapted?.American Psychological Association, 2012: 73-99https://doi.org/10.1037/13744-004
- Family practice and the quality of primary care: A study of Chinese patients in Guangdong Province.Family Practice. 2015; 32: 557https://doi.org/10.1093/fampra/cmv064
- Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes.Journal of Pediatrics. 2003; 142: 409-416https://doi.org/10.1067/mpd.2003.138
- Telehealth behavior therapy for the management of type 1 diabetes in adolescents.Journal of Diabetes Science and Technology. 2010; 4: 199https://doi.org/10.1177/193229681000400125
- Cultural differences between China and America.Kaoshi Zhoukan. 2011; (Retrieved from): 53-54
- Summer camps and quality of life in children and adolescents with type 1 diabetes.Acta Bio-medica: Atenei Parmensis. 2003; 74 (Retrieved from): 35-37
- The effect of a diabetes education, coping skills training, and care intervention on physiological and psychosocial outcomes in black women with type 2 diabetes.Biological Research for Nursing. 2010; 12: 7-19https://doi.org/10.1177/1099800410369825
- What China’s experiment in community building can tell us about tackling health disparities: Community building and mental health in mid-life and older life: Evidence from China.Social Science & Medicine. 2014; 107: 217-220https://doi.org/10.1016/j.socscimed.2014.01.026
- Randomized trial of a diabetes self-management education and family teamwork intervention in adolescents with Type 1 diabetes.Diabetic Medicine A Journal of the British Diabetic Association. 2012; 29: e249-e254https://doi.org/10.1111/j.1464-5491.2012.03683.x
- Culturally adapting a physical activity intervention for Somali women: The need for theory and innovation to promote equity.Translational Behavioral Medicine. 2017; 7: 6-15https://doi.org/10.1007/s13142-016-0436-2
- Investigating the effects of intervention intensity on skill acquisition and task persistence in children with Down syndrome.CUNY Academic Works. 2015; (Retrieved from): 1-55
- Trajectories of HbA1c levels in children and youth with type 1 diabetes.PLoS One. 2014; 9: e109109https://doi.org/10.1371/journal.pone.0109109
- Methods for the cultural adaptation of a diabetes lifestyle intervention for Latinas: An illustrative project.Health Promotion Practice. 2011; 12: 341-348https://doi.org/10.1177/1524839909343279
- Qualitative methods in health research.in: Qualitative research in health care. 3rd ed. 2007: 1-11https://doi.org/10.1002/9780470750841.ch1
- Evidences for reliability and validity of the Chinese version of general self-efficacy scale.Chinese Journal of Applied Psychology. 2001; 7: 37-40https://doi.org/10.3969/j.issn.1006-6020.2001.01.007
- The influential factors of overall life quality satisfaction degree in adolescents with type 1 diabetes mellitus.Chinese General Practice. 2013; 16: 3221-3224https://doi.org/10.3969/j.issn.1007-9572.2013.27.019
- Norm, reliability and validity of children and adolescents’ QOL scale.Chinese Journal of School Health. 2006; 27: 18-21https://doi.org/10.3969/j.issn.1000-9817.2006.01.017
- An epidemiological study on stress among urban residents in social transition period.Chinese Journal of Epidemiology. 2003; 24: 760-764https://doi.org/10.3760/j.issn:0254-6450.2003.09.004
- Type 1 diabetes prevalence increasing globally and regionally: The role of natural selection and life expectancy at birth.BMJ Open Diabetes Research & Care. 2016; 4: e161https://doi.org/10.1136/bmjdrc-2015-000161
Published online: May 27, 2020
Accepted: May 8, 2020
Received in revised form: May 6, 2020
Received: January 12, 2020
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