{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T14:36:42Z","timestamp":1793457402186,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["K12DK094721"],"award-info":[{"award-number":["K12DK094721"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["P30DK036836"],"award-info":[{"award-number":["P30DK036836"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Specialist Pediatric Nursing"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Child participation in type 1 diabetes (T1D) self\u2010care is needed in developing countries due to a lack of resources, especially during the school day. This pilot study evaluated the feasibility of a therapeutic play intervention (ITP) versus standard education (SE)\u00a0on the ability of children with T1D to correctly perform insulin injection technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>Children with T1D (7\u201312 years) were recruited at two diabetes clinics in Brazil and randomized to ITP or SE. Registered nurses received protocol training to deliver the intervention and perform data collection. ITP group received an education that included a story about a child with T1D who self\u2010injects insulin at school; SE\u00a0group received routine clinic\u2010based education. Preintervention, children were video\u2010recorded giving insulin injections to a doll; postintervention, children were rerecorded giving the doll an injection. The research team reviewed the videos and assessed the injection technique using validated checklists. Parents reported children's self\u2010injection practices at baseline and 30 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Children (<jats:italic>N<\/jats:italic>\u2009=\u200920, 40% male) were 9.6\u2009\u00b1\u20091.3 years old and had T1D for 3.6\u2009\u00b1\u20092.3 years; HbA1c was 9.1\u2009\u00b1\u20092.0%; 20% of ITP and 50% of SE\u00a0children used syringes (vs. pens) for injections. At baseline, 80% of both groups knew how to self\u2010inject; most were taught by a parent\/relative. Injection technique scores were low in both groups; ITP group increased their scores significantly postintervention. Practices of self\u2010injection did not change in either group after 30 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Practice Implications<\/jats:title><jats:p>The play\u2010based intervention appeared to improve the injection technique in the short\u2010term. Pilot findings support the development of a larger trial to evaluate the effectiveness of ITP on educating children on insulin injections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jspn.12309","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T13:10:38Z","timestamp":1600434638000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Therapeutic play to teach children with type 1 diabetes insulin self\u2010injection: A pilot trial in a developing country"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6084-3657","authenticated-orcid":false,"given":"Rebecca O.","family":"La Banca","sequence":"first","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center Harvard Medical School  Boston Massachusetts USA"},{"name":"Ribeirao Preto College of Nursing, PAHO\/WHO Collaborating Center for Nursing Research Development University of S\u00e3o Paulo  Ribeirao Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-3001","authenticated-orcid":false,"given":"Lori M. B.","family":"Laffel","sequence":"additional","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-743X","authenticated-orcid":false,"given":"Lisa K.","family":"Volkening","sequence":"additional","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8125-8967","authenticated-orcid":false,"given":"Val\u00e9ria","family":"C. Sparapani","sequence":"additional","affiliation":[{"name":"Nursing Department of Federal University of Santa Catarina  Florianopolis Santa Catarina Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0738-0539","authenticated-orcid":false,"given":"Emilia C.","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Ribeirao Preto College of Nursing, PAHO\/WHO Collaborating Center for Nursing Research Development University of S\u00e3o Paulo  Ribeirao Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7900-7111","authenticated-orcid":false,"given":"Lucila C.","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Ribeirao Preto College of Nursing, PAHO\/WHO Collaborating Center for Nursing Research Development University of S\u00e3o Paulo  Ribeirao Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S013"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12647"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i139"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.02.002"},{"issue":"5","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"7005180020p1","DOI":"10.5014\/ajot.2016.021618","article-title":"Interventions to promote diabetes self\u2010management in children and youth: A scoping review","volume":"70","author":"Cahill S. 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