ArticleDiabetic medicine : a journal of the British Diabetic Association2026
Experiences of receiving and delivering a novel complex intervention for type 1 diabetes and disordered eating: Process evaluation of the Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY).
Article in Diabetic medicine : a journal of the British Diabetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimThe Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY) intervention is a novel cognitive behaviour therapy (CBT) intervention for individuals with type 1 diabetes and disordered eating (T1DE). The aim of this mixed-method process evaluation is to assess the acceptability, appropriateness and feasibility of STEADY, and explore experiences of both participants and healthcare professionals during therapy delivery.
methodsParticipants who received STEADY (n = 13) and healthcare professionals delivering STEADY therapy (n = 3) completed person-reported outcome measures (PROMs) to assess the acceptability (AIM), appropriateness (IAM) and feasibility (FIM) of STEADY and took part in semi-structured interviews to explore experiences, therapeutic processes and implementation considerations. Interviews were analysed using thematic analysis.
resultsPROM scores indicated high ratings across participants (AIM = 18.36 ± 2.01; IAM = 18.18 ± 2.64; FIM = 18.00 ± 2.32) and healthcare professionals (AIM = 17.67 ± 2.08; IAM = 17.33 ± 2.31; FIM = 17.67 ± 2.08), suggesting high likelihood of implementation success. Thematic analysis showed significant overlap in participant and therapist experiences. Key themes included integrated T1DE-specific CBT delivery, specialist knowledge of T1DE and a strong therapeutic alliance. Both groups emphasised the need for tailored delivery, therapist expertise in T1DE and structural adaptations to standard CBT models. Participant's experiences also included a clear path of therapeutic growth and expectations of therapy. Therapists' experiences included considerations for clinical safeguarding and organisational factors impacting wider implementation.
conclusionsOur findings demonstrate that STEADY is acceptable, appropriate and feasible for individuals with mild to moderate severity T1DE. The substantial alignment between participant and therapist perspectives offers clear directions for refining the intervention and support implementation in a full-scale RCT.
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