Role of theories in school-based diabetes care interventions: A critical review

ARTICLE HIGHLIGHTS

Research background

Diabetes is one of the most prevalent child chronic conditions. School age children with diabetes need reliable, multifaceted diabetes care at school. School-based diabetes care interventions targeting school preparedness for diabetes care, involving multiple stakeholders, are warranted to improve school diabetes care quality. Applying theories makes the intervention effectiveness more promising. However, no studies systematically assessed how relevant theories were applied in existing interventions.

Research motivation

School-based diabetes care interventions benefit from applying relevant theories appropriately. The specific role of theories in existing interventions among United States K-12 schools needs to be assessed. Such studies might inform future interventions regarding applying theories in intervention design, technique selection, implementation, and evaluation and improve intervention effectiveness.

Research objectives

This study systematically identified and synthesized the literature concerning theory-based diabetes care interventions in K-12 schools in the United States. It critically assessed the specific role of theories and constructs in intervention design, implementation, outcome measurement, and evaluation. The review findings highlight the gaps and limitations in applying theory in diabetes care in schools and inform future investigations.

Research methods

This review followed a systematic review protocol for literature search, selection, and data extraction. The application of theories in the interventions that met the selection criteria was critically discussed.

Research results

Only four studies met the criteria of theory-based intervention. Three of the studies applied social cognitive theory in the implementation and evaluation process. One study applied the diffusion of innovations theory in implementation design and evaluation. Further assessment reveals the lack of use and potential misuses of theories.

Research conclusions

Existing theory-based diabetes care interventions in United States schools are few in number and lack the appropriate use of theories.

Research perspectives

Future interventions would benefit from appropriately defining, operationalizing, and measuring relevant theoretical constructs, especially the use of constructs as the core modifying factors that may contribute to intervention effectiveness.