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Balcou-Debussche M, La Hausse V, Roddier M, Sokolowsky C, Rastami J, Besançon S, Ballet D, Caroupin J, Dowlut S, Debussche X. Strengthening Health Literacy Through Structured Sessions for Non-Communicable Diseases in Low-Resource Settings: The Learning Nest Model. Community Health Equity Res Policy 2023:2752535X231184346. [PMID: 37345743 DOI: 10.1177/2752535x231184346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Health literate self-management education is at stake for the prevention and management of non-communicable diseases in low resources settings and countries. Here we describe the Learning Nest in Ordinary Context (NA-CO in French, Nids d'Apprentissage en Contexte Ordinaire) aiming at the structuring of health education programs at the micro- (education sessions) and the meso-levels (adapted to context). The Learning Nest model was designed based on a combination on health literacy principles and on studies conducted with vulnerable people with non-communicable diseases. Observation of NA-CO active-learning sessions found them to be operational and relevant as they center on access, understanding, and use of health information while integrating the ordinary context of learners. The Learning Nest packages (including several adapted thematic sessions, training of trainers and development in context) were shown to be feasible and realistic in diverse locations (Reunion, Mali, Mayotte, Mauritius, Burundi). Qualitative and intervention studies have documented the potential usefulness of the Learning Nest model for context- and setting-specific health literacy interventions.
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Affiliation(s)
| | | | | | | | | | | | - Delphine Ballet
- ICARE Research Unit, University of La Réunion, Saint-Denis, La Réunion
| | - Jessica Caroupin
- ICARE Research Unit, University of La Réunion, Saint-Denis, La Réunion
| | - Sabeena Dowlut
- Sciences de L'Education et Informatique Appliquée, Université Des Mascareignes, Beau Bassin-Rose Hill, Mauritius
| | - Xavier Debussche
- Centre Expert Plaies Chroniques, Centre Hospitalier Max Querrien, Paimpol, France
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Lormeau B, Pichat S, Dufaitre L, Chamouine A, Gataa M, Rastami J, Coll-Lormeau C, Goury G, François AL, Etien V, Blanchard JL, Hervé D, Sola-Gazagnes A. Impact of a sports project centered on scuba diving for adolescents with type 1 diabetes mellitus: New guidelines for adolescent recreational diving, a modification of the French regulations. Arch Pediatr 2019; 26:161-167. [PMID: 30885605 DOI: 10.1016/j.arcped.2018.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/25/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Recreational scuba diving has been authorized for type 1 diabetics over 18 years old - the age of majority in France - since 2004, but it remained forbidden for younger diabetics by the French underwater federation (FFESSM). Here, we present a study to evaluate: - the conditions under which diving could be authorized for 14- to 18 year olds with type 1 diabetes; - the value of continuous glucose monitoring (CGM) while diving. A secondary objective was to monitor the impact of diving on the teenagers' quality of life. SUBJECT AND METHODS Sixteen adolescents (14-17.5 years old) were included. Diabetes was known for 6 years (range, 1-14) and Hb1Ac was 9.0% (range, 7.7-11.9). The study was conducted in Mayotte with both capillary glycemia (CG) and CGM measurements taken during five dives. RESULTS The average CG prior to diving was 283mg/dL and decreased by 75±76mg/dL during the dive. No hypoglycemia occurred during the dives and four episodes occurred after. Glycemia variations during dives and for the overall duration of the study were greater than for adults, most likely due to the general adolescent behavior, notably regarding diet and diabetes management. CGM was greatly appreciated by the adolescents. They had an overall satisfactory quality of life. No significant variations were observed during the entire course of the study. CONCLUSIONS Although in need of further studies, these preliminary results show that CGM can be used while diving. CGM records show a continuous decrease of glycemia during dives. Based on these results, the French underwater federation has now authorized diving for adolescent type 1 diabetics following a specific diving protocol that includes HbA1c<8.5%, autonomous management of diabetes by the adolescent, reduction of insulin doses, and target glycemia prior to the dive>250mg/dL.
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Affiliation(s)
- B Lormeau
- Diabetologist, 5, rue du marché, 93160 Noisy le Grand, France
| | - S Pichat
- Université de Lyon, ENS de Lyon, 46, allée d'Italie, 69364 Lyon cedex 7, France; Association diabète et plongée, MDA1, 5, rue du Louvre, 75001 Paris, France.
| | - L Dufaitre
- Service diabétologie - endocrinologie, hôpital Saint-Joseph, 26, boulevard de Louvain, 13008 Marseille, France
| | - A Chamouine
- Pôle pédiatrie, centre hospitalier de Mayotte, rue de l'Hôpital, BP 04, 97600 MaMoudzou, Mayotte
| | - M Gataa
- Réseau diabète (Rédiab Ylang 976), rue de Cavani, 97600 MaMoudzou, Mayotte
| | - J Rastami
- Association AJD 976, 19, rue Cavani, 97615 Pamandzi, Mayotte
| | - C Coll-Lormeau
- Nurse, 53, avenue Aristide-Briand, 93160 Noisy le Grand, France
| | - G Goury
- Association diabète et plongée, MDA1, 5, rue du Louvre, 75001 Paris, France
| | - A-L François
- Association diabète et plongée, MDA1, 5, rue du Louvre, 75001 Paris, France
| | - V Etien
- Association diabète et plongée, MDA1, 5, rue du Louvre, 75001 Paris, France
| | - J-L Blanchard
- FFESSM (French underwater federation), 24, Quai de Rive-Neuve, 13284 Marseille cedex 07, France
| | - D Hervé
- Direction de la jeunesse, des sports et de la cohésion sociale (DJSCS) de Mayotte, Bat. A et B, rue de l'Archipel, BP104 Kaweni, 97600 MaMoudzou, Mayotte
| | - A Sola-Gazagnes
- Unité fonctionnelle diabétologie, immunologie clinique, hôpital Cochin AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
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Bauduceau B, Bertoglio J, Charrière S, Joly M, Mourey C, Rastami J. [Diabetes training in Mayotte]. Soins 2013:23-24. [PMID: 24218914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In 2012, the paramedical Francophone Diabetes Society (SFD) visited Mayotte in the context of a training programme for health professionals. The training addressed diabetes prevention, self-monitoring of blood glucose and treatment management while respecting the population's cultural habits.
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Affiliation(s)
- Bernard Bauduceau
- SFD paramédical, 88, rue de la Roquette, 75544 Paris cedex 11, France
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