{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:45:31Z","timestamp":1790379931899,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Diabetes distress is highly prevalent among adults with type 1 diabetes, yet remains under\u2010recognised and rarely addressed in routine diabetes care. This rapid realist review aimed to identify how, why, for whom, and in what contexts group\u2010based interventions reduce elevated diabetes distress in adults with type 1 diabetes, to inform the co\u2010adaption of a new diabetes distress intervention in the UK (\u2018D\u2010Stress Reduce\u2019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following established rapid realist review methods, we synthesised evidence from 27 papers relating to two existing diabetes distress interventions and the psychological and social theories underpinning them. Data extraction and analysis focused on identifying contexts, mechanisms and outcomes, supported by stakeholders including methodological experts and programme architects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven programme theories were generated and articulated through 20 \u2018If\u2010Then\u2010Because\u2019 statements. Key theories highlighted emotional regulation, peer support and person\u2010centred facilitation in reducing diabetes distress. Other theories included regular assessment and follow\u2010up, motivation for action, and empowerment in self\u2010management. The review found that interventions were most effective when adults with type 1 diabetes reported feeling emotionally safe, listened to and respected, and when group facilitators shifted from directive, hierarchical communication styles to collaborative approaches. Contextual factors, such as group composition, facilitator skill, and individual readiness for change influenced outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review provides a theory\u2010driven foundation for developing, implementing and evaluating a new co\u2010adapted diabetes distress intervention in the UK (\u2018D\u2010Stress Reduce\u2019) and highlights multiple components that can be addressed to improve the care pathway and group\u2010based experience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70242","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T04:31:22Z","timestamp":1770957082000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Group\u2010based interventions to reduce diabetes distress in adults with type 1 diabetes: A rapid realist review of the Reduce and TunedIn interventions"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7494-9030","authenticated-orcid":false,"given":"Sarah","family":"Sims","sequence":"first","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke","family":"Stenov","sequence":"additional","affiliation":[{"name":"NAMU \u2010 National Center for Applied Research in Older Citizens Living with Multimorbidity Univeristy College Absalon  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Due\u2010Christensen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Region H  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9481-9727","authenticated-orcid":false,"given":"Lawrence","family":"Fisher","sequence":"additional","affiliation":[{"name":"University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Fabian\u2010Therond","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Peck","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Ahuja","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"O'Connor","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Abrams","sequence":"additional","affiliation":[{"name":"University of Surrey  Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Halliday","sequence":"additional","affiliation":[{"name":"School of Psychology, Institute for Health Transformation Deakin University  Geelong Victoria Australia"},{"name":"The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria  Carlton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8911-6744","authenticated-orcid":false,"given":"Richard I. G.","family":"Holt","sequence":"additional","affiliation":[{"name":"University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1204-6896","authenticated-orcid":false,"given":"Jane","family":"Speight","sequence":"additional","affiliation":[{"name":"School of Psychology, Institute for Health Transformation Deakin University  Geelong Victoria Australia"},{"name":"The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria  Carlton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1281-1401","authenticated-orcid":false,"given":"Jackie","family":"Sturt","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Harris","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"D\u2011Stress Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13448"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15446"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1970"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13381"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12428"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2020.02.004"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-022-03821-w"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05568-3"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-SINT"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14919"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-015-0694-2"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-015-0660-z"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1179\/2057332415Y.0000000004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0391"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2452"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15187"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2196\/58658"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-8-103"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-21"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-11-115"},{"key":"e_1_2_11_22_1","unstructured":"WongG PawsonR GreenhalghT.Realist synthesis Rameses training materials. 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