1. Families, Adolescents & Children Teamwork Study 2 Ipswich Paediatric Diabetes Team C Wadham, HR Murphy, AJ Byard, TC Skinner, J Hassler- Hurst, J Buck, S Cradock, A Scott, G Rayman

2. Update on FACTS 2 ….  150 adolescents recruited  4 centres delivering - Ipswich - Peterborough - Norwich - Coventry and Nuneaton  3 - 4 centres potentially starting Sept ‘ 08  Potential for 1 - 2 more sites

3. Aim of programme ………. To help the young person with diabetes cope better with diabetes by shared and informed decision-making in order for them to fulfil their potential.

4. Evidence ………………..  FACTS 1  Hvidore study Agreed Family targets responsibility

5. Educator discussion ……….. accumulated data discussion consensus Targets BG ’ s, HbA1c, sick days, CHO counting CLARITY & DOCUMENT

6. Intended Outcomes …………  Explore and agree roles and responsibilities that promote family functioning.  Increased knowledge and opportunity to apply practical skills in relation to food choices and insulin dose adjustment.  Practice open family communication.  Explore issues around family conflict / promote conflict resolution and inter-dependence.

7. Development of a philosophy ….  Discussion with external facilitator  Formalise  Spreading the word  Engage

8. Key Educator Behaviours …………………..  Explore and build upon patient ’ s knowledge by the use discovery questions and of reflection  Support families to work together to enable goal setting with the child rather than FOR!  Safe environment to explore feelings / emotions and acknowledge distress

9. Curriculum development ……..  6 sessions 90 minutes duration skills training communication  External review to identify and reinforce key educator behaviours  Ongoing revision – dynamic and evolving BEHAVIOURS ARE KEY

10. Behaviour 1 Discovery questions  What do you think?  How do you feel about that?  What makes you say that?  Could you explain that further?  What would you like to happen in that situation?  How could this be achieved?  What does the rest of the group think?  It sounds to me as if you are saying ….

11. Behaviour 2 Shared goal setting  Family responsibility questionnaire

12. Behaviour 3 Safe environment  Attitude / approach – informal, non-judgmental, humorous  Confidence - educator and participant  Variety of techniques – drawing, post-its, work stations, small group discussions

13. Participant feedback ………  ” Helpful to let you know that talking is a big part of getting things right ” and “ also seeing how parents think and respond ” (Young Person)  “ Lots of value in hearing other ’ s experiences in all the sessions ” (Parent)  “ It was good cos there was bits just the kids could talk ” (Young Person)  “ I really enjoyed the time on the course, it made us both think about things from a different angle, and got us talking ” (Parent)

14. Thank you for your attention.