The DAWN MIND Youth programme
™
™
GlobAl
About the programme
The DAWN™ Youth study highlighted the importance of addressing a range of psychosocial
issues as part of regular paediatric diabetes care. The International Society for Pediatric and
Adolescent Diabetes (ISPAD) guidelines recommend that: ‘Assessment of developmental
progress in all domains of Qol (i.e., physical, intellectual, academic, emotional, and social
development) should be conducted on a routine basis’.1,2
Until recently, there were no guidelines or research-based tools that could support the
integration of psychosocial needs assessment into the routine care of young people with
diabetes.
As part of the DAWN™ Youth initiative, a global Novo Nordisk initiative started in
partnership with the International Diabetes Federation (IDF) and the International Society
for Paediatric and Adolescent Diabetes (ISPAD), and overseen by the DAWN™ Youth
international advisory board, Novo Nordisk developed the DAWN™ MIND™ Youth
programme in 2009-2010. The programme is built on the global DAWN™ Youth survey
results and its aim is to promote the assessment of health-related quality of life (HRQol) as
part of routine outpatient care for young people with diabetes.
The DAWN™ MIND™ Youth programme includes MIND™ Youth (MY-Q), a psychometrically
validated psychosocial needs assessment questionnaire, a web-based software programme
that facilitates completion and evaluation of the questionnaire, and a manual for healthcare
professionals (HCPs) offering guidance on how to score the results and communicate
effectively with people with diabetes.
Training will be offered to all the participating HCPs prior to starting the DAWN™ MIND™
Youth programme.
MY-Q – the MIND Youth Questionnaire
The development of the MY-Q questionnaire was led by Maartje De Witt, of the
Department of Medical Psychology, Vrieje University, Medical Center, Amsterdam. The MY-Q
is the first validated HRQol measure for teenagers with diabetes, specifically designed for
routine clinical use, in compliance with international recommendations.1,2 The questionnaire
is completed online, either at home or at the clinic, before the routine annual assessment,
in a password-protected, secure web-based software programme. Prior consent is required
from both the young person and their parent or carer. Most of the questionnaire’s
GeNerAl QuAlITY of lIfe
(Qol)
10
Here is a picture of a ladder.
The top of the ladder ‘10’ is
the best possible life for you
and the bottom ‘0’ is the
worst possible life for you. In
general, where on the ladder
do you feel you stand at the
moment? Tick the number that
suits you best.
8
9
socIAl lIfe (friends, family, and school)
Sample question:
Always
7
6
5
4
3
2
1
How often does diabetes
limit your friendships and
relationships?
often
Very
seldom
DIAbeTes MANAGeMeNT
(worries, treatment barriers, self – efficacy
and satisfaction, and problematic eating)
Never
Always
✓ ✓
I have been trying to control my weight
or shape in different ways
✓
✓ ✓
In how many of the past 14 days
The DAWN MIND Youth web-based software programme
™
Very
Never
seldom
✓ ✓
No days
... have you had eating binges?
... have you omitted on purpose?
1-3
days
eMoTIoNAl Well-beING
In the past 2 weeks ...
constant Most >50%
of the of the
time time
>50%
of the
time
some At no
of the time
time
I have felt cheerful and in good
spirit
I have felt calm and relaxed
✓ ✓
0
™
often sometimes
I’m happy with the way I look
I get along with other
people of my age
other people of my age
bully me
sometimes
36 questions use a likert scale pertaining to frequency or intensity, allowing respondents to
evaluate themselves in the areas of general quality of life, social life, diabetes management
and emotional health. Any positive or negative events the young person has experienced in
the recent past are taken into account via two open-ended questions, and the young person
is also invited to raise any other issues they would like to discuss with the healthcare team.
Sample questions are shown below:
4-7
days
8-10
days
12-14
days
✓ ✓ ✓
✓ ✓ ✓ ✓
I have felt active and vigorous
I woke up feeling fresh and rested
My daily life has been filled with
things that interest med
At a score <13:
5
4
3
2
1
0
Implementation and evaluation
This secure web-based software programme supports interaction between young people
with diabetes, their parents and healthcare teams. The young people with diabetes can
complete the MY-Q questionnaire and submit it remotely via the programme, either at home
or at the clinic, before the routine annual assessment.
resulTs ANAlYsIs
The answers are compiled by computer
software and provided to the HCPs for
immediate follow-up in discussion with
the respondent. The software generates a
graphical summary of the results, allowing the
HCPs to pinpoint any psychosocial issues. The
results are filed so changes over time can be
detected, and referral to a psychologist can
be made if needed. Guidance of the HCPs in
effective discussion and motivation (of both
young people with diabetes and their parents)
is included in the programme.
suMMArY of psYchosocIAl Issues
(sample) automatically generated for
healthcare team
IMpleMeNTATIoN
eVAluATIoN
The DAWN™ MIND™
Youth programme
has already been
implemented in the
Netherlands, with
15 clinics using the
programme for two
years.
• The DAWN™ MIND™ Youth System and MY-Q
Questionnaire are well-tested and proven to be highly
acceptable and feasible in busy paediatric diabetes care
settings.
• The system provides clinics with invaluable data about the
psychosocial well-being and priorities of young people
with diabetes
• DAWN™ MIND™ Youth helps detect and address
psychosocial challenges that young people with diabetes
face. These challenges interfere with self-management and
affect quality of life
• While improving relations between young people with
diabetes and their clinics, DAWN™ MIND™ Youth can also
help improve detection of mental health problems, which
are more prevalent in young people with diabetes.
Next steps
• The MY-Q Questionnaire exists in multiple languages and can be obtained for scientific and
clinical purposes by contacting Martje De Witt, Department of Medical Psychology, EMGo
Institute for Health and Care Research, VU University Medical Center, Amsterdam
• The DAWN™ MIND™ youth programme and related internationally validated training
programmes on psychosocial management in paediatric diabetes are available for adaptation
and implementation at local level.
for further details on local implementation, please contact your local
Novo Nordisk office.
1. Global IDF/ISPAD Guideline for Diabetes in Childhood and Adolescence
2. Delamater AM. Psychological care of children and adolescents with diabetes. Pediatr Diabetes 2007; 8:340–348