Young people with diabetes and their peers - an exploratory study of peer attitudes, beliefs, responses and influences

Peer relations are of increasing importance to young people who spend more time outside their home environment and look towards peers for information on behavioural norms. Achieving optimal self-management of diabetes can be particularly challenging for adolescents, and relationships with others can impact on this. The evidence that other people are important for young people with diabetes in terms of both condition management and other psychosocial outcomes comes largely from studies looking at adolescents in their family setting. Whilst it is recognised that peers are likely to be important in this respect, little research has been undertaken in this area, especially looking at what peers themselves think about the condition and their responses to it. In this research, we used well-established in-depth qualitative research methods (interviews and focus groups) to explore peer beliefs and attitudes towards diabetes from the perspectives of both young people with diabetes and their peers. We interviewed 10 young people with diabetes and a close friend they nominated to take part in the research with them. We also conducted three focus groups with secondary school pupils with no necessary prior knowledge of diabetes. In the focus groups, we used short realistic descriptions (vignettes) of young people with diabetes to facilitate discussion – these vignettes were developed using ideas taken from our interviews with young people with diabetes and their friends and with help from young people on our project steering group. We also piloted some educational materials about diabetes with our focus group participants which we again developed with the help of our steering group and research interview participants as well as useful feedback from a parent of a young person with diabetes.

We found that there were significant differences reported in the support offered in schools to young people with diabetes. Those young people with diabetes we spoke to who reported that they were well supported at school by teaching staff seemed to be more comfortable in dealing with their condition, and more open with regards to their condition and its management with their friends and peers. Overall, our research participants suggested that there was a need for greater awareness of diabetes and for more education about the condition in schools. Participants suggested that this would help normalise the condition and that young people with the condition would thus be less likely to be the focus of unwanted attention. The educational materials we piloted with our focus groups in secondary school settings were well-received and easily graspable by our participants. Findings from this study suggest that more education about diabetes amongst young people is needed, but also encouragingly that this would be welcomed by young people themselves. We hope to use this work to develop a larger scale project to increase awareness of diabetes in school settings amongst both pupils and teaching staff.