Degree Name

Doctor of Philosophy


Faculty of Education


Internet-based communication technologies and participatory software tools have created new opportunities for teaching and learning. Research determining the principles required for effective application of these innovations for children and adolescents is limited. This study focused on determining the principles required for effective and appropriate use Internet-based communication technologies for the education and support of young people living with diabetes.

Type 1 diabetes is a life threatening disease, thus education aimed at developing competent self-management behaviours is vital in order to avoid serious complications (Court, Cameron, Berg-Kelly, & Swift, 2009; DCCT, 1993). Existing diabetes education models are often limited, yet there are calls for more accessible, ongoing, and adaptable education, which is integrated into routine clinical care (Swift, 2009). The Internet provides an opportunity to provide ongoing patient-centred education, but there has been little exploration of how Internet-based communication technologies can be used to provide effective, sustained, and accessible diabetes education. Thus the focus of this study was to identify the design principles that underpin an effective Internet-based learning environment about diabetes specifically aimed at children and adolescents. Two research questions guided this research: 1. What are the critical design principles and characteristics of Internet-based learning environments for young people who are living with type 1 diabetes? 2. What factors and processes do designers need to consider when building an online learning environment for young people living with Type 1 diabetes?

Children aged 11-13 years were the focus of this study, and the setting was the Diabetes Unit at the Women's and Children's Hospital in Adelaide, South Australia. A pragmatic mixed-method approach was adopted and conducted in four Phases using a Design-Based Research framework. Phase 1 focused on determining design and implementation issues from the perspectives of the key stakeholders: children, parents, young diabetic adults, and clinicians. Formative evaluation methods were used in Phase 2 to develop a prototype Internet-based learning environment intervention. Phase 3 involved two cycles of testing and refinement of the prototype design solution. Cycle 1 consisted of a four-week implementation with six children, with a primary focus on the usability of the online learning environment. Refinements were made to the prototype design, and a revised prototype was tested in Cycle 2 with 10 children over nine weeks. The evaluation of Cycle 2 focused on the effectiveness of the online learning environment in terms of its potential as a learning tool.

Key findings from the study included the importance of creating and supporting secure, private Internet-based social connections between children. New links between children, parents and clinicians were created and highly valued, and pedagogies that focus on authentic shared learning activities that are based on real-life problems resulted in diabetes self-management competency development. A reflection of the findings was conducted in Phase 4 culminating into four design principles being recommended: 1. Enable ways to provide secure online social interactions for young people and parents 2. Actively involve and support parents 3. Provide engaging real-life learning contexts that facilitate diabetes selfmanagement competencies 4. Implement expert coaching, guidance, and facilitate access to modelling.

This study has demonstrated that new and emerging Internet-based communication technologies can address the considerable problems of providing ongoing and effective hospital-based diabetes education and psychosocial support for young people living with diabetes. Recommendations for future research include further refinements of the design, implementation for longer periods of time and in wider contexts, and support for clinicians in the use of Internet-based learning environments is essential.