The adaptation of an eating disorder prevention intervention to a wales diabetes context: application of the ADAPT guidance to clinical context

Jess Broughton; Aisling Pigott; Daniel Heggs; Katherine Gallimore; Amie-Louise Prior; Whelan Cass; Naomi Durham; Durham Duke Al; Gracie Stevens; Gareth Davies; Lili Hicks; Kieren Callaghan; Alys Griffin; Fran Norris; Sara Crowley; Sarah Harris; Selina Martin; Simon Fountain-Polley; Sophie Nicholls; Aimee Grimwood; Stephanie Griffiths; Rhiannon Miskin; Rachel Humphreys

doi:10.1530/endoabs.111.P44

P44

Prev Next

Section Contents Cite

Endocrine Abstracts (2025) 111 P44 | DOI: 10.1530/endoabs.111.P44

BSPED2025 Poster Presentations Diabetes 3 (10 abstracts)

The adaptation of an eating disorder prevention intervention to a wales diabetes context: application of the ADAPT guidance to clinical context

Jess Broughton ¹ , Aisling Pigott ² , Daniel Heggs ² , Katherine Gallimore ² , Amie-Louise Prior ² , Whelan Cass ² , Naomi Durham ³ , Duke Al Durham ³ , Gracie Stevens ³ , Gareth Davies ³ , Lili Hicks ³ , Kieren Callaghan ³ , Alys Griffin ³ , Fran Norris ⁴ , Sara Crowley ⁴ , Sarah Harris ⁴ , Selina Martin ⁴ , Simon Fountain-Polley ⁴ , Sophie Nicholls ⁴ , Aimee Grimwood ⁴ , Stephanie Griffiths ⁴ , Rhiannon Miskin ⁴ & Rachel Humphreys ⁴

Author affiliations

¹Cwm Taf Morgannwg University Health Board, Bridgend, United Kingdom; ²Cardiff Metropolitan University, Cardiff, United Kingdom; ³Expert by experience, Wales, United Kingdom; ⁴Expert by Occupation, Wales, United Kingdom

Introduction: Individuals with Type 1 Diabetes (T1D) face a significantly higher risk of eating disorders, with prevalence estimates of up to 10% for clinical eating disorders and 40% for disordered eating behaviours. Despite these risks, paediatric diabetes care remains predominantly focused on prevention of physical complications, with limited integration of psychological risk reduction especially around eating disorders. Early, structured prevention strategies that incorporate psychological and educational support are necessary to address this gap.

Aim: This adaptation work applies the MRC/NIHR ADAPT framework to modify an evidence-based eating disorder prevention intervention for a Welsh population of children and young people living with T1D.

Methods: The adaptation process followed the ADAPT framework, incorporating six stakeholder workshops. The research team engaged 12 healthcare professionals (experts by occupation, EbO) and 7 individuals with T1D (experts by experience, EbE), supported by the NHS Executive Diabetes Transitional Care Coordinator. Stakeholders reviewed existing interventions, identifying the Diabetes Body Project and the recommended modifications to enhance relevance for a Welsh population.

Results: Adaptations to Diabetes Body Project EbO and EbE stakeholder workshops

Table 1
	Diabetes Body Project	Diabetes Body Project Cymru
Age of intervention	Aged 14-35	Aged 11-13
Population	Females with Type 1 Diabetes	All young people with Type 1 Diabetes
Delivery	Experiencing some level of body image concerns	Embedded within routine paediatric diabetes care
Target group	Young People	Young people with supporting information for parents and training for paediatric diabetes team
Underpinning theory	Cognitive dissonance with Cognitive Behaviour Therapy (CBT)	Acceptance Commitment Therapy (ACT) with focus on increasing Psychological Flexibility through building skills around Cognitive Defusion and Values Based Action.
To Reduce	Thin ideal	Perfect ideal (including body image and diabetes)
Inclusion of Diabetes	Introduced later in the manual	Included throughout
Structure	6 x 1 hour sessions online	4 x 1.5 hours face to face
Outcome measures	EDDI, HbA1c, TIR Demographics, DEBQ-RS, BDI, PANAS, IBIS-R, PAID, DEPS-R, Health Care Utilisation, T1DAL	HbA1c, TIR Demographics, Parent Reported DEPS-R, SEEDS, CompACT-Y, PAID-T

Discussion: Further stakeholder sessions will refine outcome measures and intervention logic models. Adaptations subject to approval from the Diabetes Body Project team.