Supporting Parents of Children With T1D
Mandy Jansen, Inge H. H. Coenders, Paul G. Voorhoeve, Lianne Wiltink, Nicole Boerboom, Lobke M. Silberbusch, Noortje Zandbelt, Sabine Mulder, Dieuwke Fossen, Marlene M. A. De Haan, Miriam Douma, Judith B. Prins and Giesje Nefs
Parents’ Experiences and Perceived Benefits of a Parent Program in Pediatric Type 1 Diabetes.J Fam Nurs. 2026 Jul 29:10748407261464914.
Managing type 1 diabetes (T1D) in childhood affects the whole family. Parents play an important role in diabetes management, but finding the right balance between staying involved and giving their child increasing independence can be challenging. Supportive communication and collaboration are therefore important parts of diabetes care.
The Dutch “LosVast” (“Loose-Tight”) program was developed specifically for parents of children with T1D. Through group sessions, it aims to strengthen positive parenting and communication skills and improve parent-child collaboration around diabetes. The program combines practical exercises and information with discussions and exchange of experiences between parents.
In this mixed-methods study, researchers evaluated parents’ experiences with LosVast in routine diabetes care. Satisfaction data were available from 113 parents of children aged 4–19 years, while 38 parents from 28 families participated in interviews. The researchers were particularly interested in understanding what works, for whom, why and under what circumstances.
Key findings:
- Parents were generally positive about the program: On a scale from 1 to 7, average satisfaction was 5.4 and the average likelihood of recommending LosVast to others was 5.5.
- The program encouraged parents to reflect on their parenting: Almost all parents reported becoming more aware of their communication, reactions and family dynamics around diabetes. For some, this confirmed that they were already approaching diabetes management in a supportive way.
- Some parents changed how they communicated with their child: Examples included listening more, asking open questions rather than immediately giving instructions, responding more calmly when diabetes management was suboptimal, giving more positive feedback and reconsidering how diabetes responsibilities were divided between parent and child.
- Changes in parenting were most apparent in families already experiencing some difficulties: Parents with moderate pre-existing challenges in parent-child collaboration appeared to benefit most from the program content. Parents with few difficulties often already used the suggested strategies, whereas families facing substantial difficulties sometimes felt that the program did not provide enough individualized support.
- Peer support was one of the most valued aspects of LosVast: For many parents, exchanging experiences with other families was even more valuable than the program content itself. It helped parents feel understood and less alone, normalize their experiences and learn from how other families manage similar situations.
- Who is in the group matters: Peer support worked particularly well when parents had children of similar ages and faced comparable challenges, while including some families with more diabetes experience provided opportunities to learn about challenges that might lie ahead. Large differences between families could reduce recognition and were associated with dissatisfaction or dropping out.
The findings suggest that LosVast can provide parents with a valuable opportunity to reflect on diabetes-related parenting and learn from other families. Importantly, there is no single approach that works equally well for every family: matching the program to families’ needs and carefully considering group composition appear important. Guided peer exchange emerged as a particularly valuable element of the program.
Because this was an observational evaluation without a control group, the study cannot establish that LosVast itself caused the reported changes. Longer-term research is needed to determine whether increased awareness and changes in parenting are sustained over time
Concluding, the authors state
“Our findings highlight the potential of the ‘LosVast’ program as a platform for families to jointly reflect on and improve diabetes-related family dynamics.”
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