Diabetes@School: How Health Communications Can Fill a Public Policy Gap

Background:

When there is no policy mechanism to ensure supports to students with medical needs, it can be challenging for parents to keep their children safe and healthy during the school day. Type 1 diabetes, a condition where the pancreas stops producing insulin, requires round-the-clock management. Checking blood sugar, counting carbohydrates, administering insulin, and monitoring physical activity are essential daily activities for the 1 in 300 children who are affected. The fastest growing group of new diagnoses are kids under 5 years, so most schools have at least one student with the condition. Depending on their age and stage, children need help with some or all of their daily tasks at school. Because many provinces and territories have no formal supports in place for students with type 1 diabetes, training and resources are limited and inconsistent.

Program background:

In 2014, the Canadian Paediatric Society (CPS) and the Canadian Pediatric Endocrine Group (CPEG) published recommendations on managing type 1 diabetes in school, and began advocating to provincial ministries of education for improved support. Developing public policy is a protracted process, so the CPS and CPEG joined with Diabetes Canada to develop a health communications program to ensure resources were available to all school staff to support students with type 1 diabetes. Diabetes@School (www.diabetesatschool.ca), the first national initiative to provide education and training on type 1 diabetes for teachers and other school staff, was launched in 2016. The profile of the program allowed the partners to play an important role in the development of the Ontario government’s policy on prevalent medical conditions in school. When the Ontario Ministry of Education released its policy on prevalent medical conditions in 2017, Diabetes@School was integrated into its policy implementation framework.

Evaluation Methods and Results:

In 2017, we conducted a baseline survey of Ontario parents of children with type 1 diabetes. Nearly one-third parents said they were not confident that school staff can keep their kids with type 1 diabetes safe. The survey also found that:

• More than half of school-aged kids with type 1 diabetes do not have individual care plans;
• 21% of parents reduce their child’s insulin at least once a week because they are concerned about hypoglycemia (low blood sugar) at school; and
• Nearly 13% of parents go to their child’s school at least once a week to monitor their care.

We expect that the roll-out of policies in school board across Ontario, along with the use of Diabetes@School into school staff training, will help to improve the confidence of Ontario parents, as well as the number of children with individual care plans. This survey will be repeated in 2019.

Conclusions:

Health communication can support public policy implementation, but it can also help drive the development of policy where there is a void. Diabetes@School is an example of this, and can be used as a model for other health concerns.

Implications for research and/or practice:

Involving health communicators in the policy advocacy process can strengthen the effectiveness of efforts. Being able to support the policy implementation process can help reassure policy-makers.