The perspectives of diabetes educators on the provision of type 1 diabetes education in schools: a comparison across geographical regions of Australia

Background As children and adolescents generally spend a large proportion of time at school, it is essential that their type 1 diabetes (T1D) management follows best practice guidelines during school hours. This can generally be achieved if school staff are trained and supported in T1D management. This study investigated the provision of diabetes education to school staff supporting students with T1D, across different geographical areas of Australia, from Diabetes Educators (DE) perspectives. Methods This was a sequential mixed-methods study using individual, semi-structured interviews and an online questionnaire. Place of employment comparison was undertaken as major city, or other (inner regional, outer regional and remote). Results Fifteen semi structured interviews with DEs identified three main themes: the current situation, ideal education, and barriers to ideal education. Twenty-seven questionnaire respondents were compared based on major city or other areas. Value of glucagon training, and refusal to administer insulin or glucagon was reported more from other areas, while camp planning and telehealth was reported more in major cities. Conclusion Given Australia's size and regional diversity, one model for school-based diabetes education is unlikely to work across all areas. Multilevel barriers exist, with the most affected by geographical location including delivery methods, time and resources, particularly lack of funding. Implications for practice Barriers to optimal diabetes education in schools are likely not limited to Australia, highlighting the need for a consistent global approach. International policy harmonization and further research into diabetes education across camps, extracurricular activities and rural school health practices are warranted.