Evidence map›Paper›PMID 39910931›Full record

ArticleHealth expectations : an international journal of public participation in health care and health policy2025

Developing a Quality Improvement Framework to Enhance the Health System User Experience for Individuals Living With Type 1 Diabetes: The Reshape T1D Study.

Jamie Boisvenue, Youssef A Elezzabi, Kim Young, Kathleen Gibson, Heather Hinz, Reid McClure, Robyn Homulos, Jude Spiers, Peter Senior, Roseanne Yeung

Abstract read
In one paragraph

Article in Health expectations : an international journal of public participation in health care and health policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. From language matters to stigma-free communication in diabetes: Evolution, challenges, and next steps.Diabetic medicine : a journal of the British Diabetic Association · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jamie BoisvenueDepartment of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-3344-7952
Youssef A ElezzabiPatient Co-Researcher, University of Alberta, Edmonton, Alberta, Canada.
Kim YoungAlberta Health Services, Edmonton, Calgary Alberta, Canada.
Kathleen GibsonPatient Co-Researcher, University of Alberta, Edmonton, Alberta, Canada.
Heather HinzPatient Co-Researcher, University of Alberta, Edmonton, Calgary Alberta, Canada.
Reid McClureAlberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
Robyn HomulosAlberta Health Services, Edmonton, Alberta, Canada.
Jude SpiersFaculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Peter SeniorDepartment of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Roseanne YeungDepartment of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.

Funding

This study was funded by the Alberta Diabetes Institute, Alberta Physician Learning Program, University of Alberta School of Public Health, Alberta Strategy for Patient-Oriented Research Support Unit, Diabetes Action Canada, Alberta Health Services, and the Alberta Government. All Patient Co-Researchers received honoraria for this work.
6 · The paper itself

Abstract

introductionUser experience design aims to create products and services that are accessible, usable, and enjoyable. The Reshape T1D study aims to apply these principles to understand how individuals living with T1D interact with and experience healthcare to inform T1D clinical quality improvement.

methodsUsing a community-based participatory research design, we involved four patients and four clinicians as co-researchers throughout the research. A questionnaire and virtual semi-structured interview were applied across a purposeful sample of 41 adults living with T1D across Alberta, Canada, between September 2021 and May 2022. Audio recordings were transcribed verbatim and de-identified before coding. Thematic analysis was conducted on coded participant discourse through multiple coders.

resultsParticipants indicated the need for a centralized hub that provides consistent, reliable, and up-to-date T1D education and resources and an emphasis on access to mental health resources within T1D care settings. Providing greater flexibility for appointment types (ie. in-person, virtual, etc.) and after-hours access contributed to better self-management and prevented emergency room visits. Participants desired a choice as to who comprises their T1D care team and for teams to address patient needs specific to their reality. We identified that medical trauma had long-term impacts on perceptions of healthcare and contributed to a reluctance to seek future care. Women expressed challenges in discussing reproductive health with their clinicians. Diabetes online communities provide an adjunct to clinical care through peer support. Cost and access to the latest technology are ongoing barriers for many participants, especially concerning publicly funded programmes that use advanced insulin pump therapy, continuous glucose monitoring, and automated insulin delivery systems. A quality improvement framework emerged through data analysis, and findings were synthesized into actionable recommendations for ongoing clinical quality improvement.

conclusionOur findings highlight how important health system user suggestions are for more equitable, accessible, and empathetic healthcare for individuals living with T1D. Further work is needed to explore health system user experiences with clinicians and healthcare administrators to effectively carry out T1D clinical quality improvement.

Indexed as

Diabetes Mellitus, Type 1Quality ImprovementAdultAlbertaCommunity-Based Participatory ResearchFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchSelf-ManagementSurveys and Questionnairescommunity‐based participatory researchdiabetesendocrinologypatient‐centered carequalitativetype 1 diabetes

Identifiers

PMID39910931
PMCPMC11799594

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.