Effects of Peer-Based Experiential Education on Psychosocial Adaptation in Adolescents with Type 1 Diabetes: A Randomized Controlled Trial.

BACKGROUND: Adolescents with Type 1 diabetes face significant challenges in achieving effective self-management and maintaining psychosocial well-being. Peer-based and participatory health education approaches, grounded in Social Learning Theory, may strengthen adolescents' motivation, confidence, and experiential learning in diabetes care. AIM: This study aimed to evaluate the effectiveness of a peer-based participatory health education program on psychosocial adaptation outcomes - self-efficacy, illness attitudes, and diabetes knowledge - and to explore its short-term effects on glycemic control among adolescents with Type 1 diabetes. METHODS: A parallel-group randomized controlled trial was conducted with 46 adolescents aged 13-18 years with suboptimal glycemic control (HbA1c > 7.5%), recruited from a tertiary pediatric endocrinology clinic. Participants were randomly allocated to an intervention group (n = 23) or a control group (n = 23). The intervention group received a seven-week peer-based experiential education program including group discussions, exercise activities, and a kitchen workshop, while the control group received routine individual education. Data were analyzed using appropriate parametric and non-parametric tests with a significance level of p < .05. RESULTS: Adolescents in the intervention group showed significantly higher posttest scores for self-efficacy, illness attitudes, and diabetes knowledge compared with the control group (p < .01). Within-group analyses demonstrated significant improvements in psychosocial outcomes among intervention participants, whereas no meaningful change was observed in the control group. Although HbA1c levels decreased slightly in both groups over the three-month follow-up period, the between-group difference was not statistically significant. CONCLUSION: Peer-based participatory health education improved psychosocial outcomes among adolescents with Type 1 diabetes. Incorporating peer interaction and experiential learning into diabetes education programs may strengthen psychosocial adaptation and support the foundations of effective self-management.