Insights Into How Digital Health Interventions Shape Outcomes for Emerging Adults Living With Type 1 Diabetes: Qualitative Realist Process Evaluation

Ruoxi Wang   ¹ , PhD ;   Balpreet Panesar   ¹ , PhD ;   Mikayla Sonnenberg   ^{2, 3} , BASc ;   Alanna Landry   ⁴ , RN ;   Anne-Sophie Brazeau   ⁵ , RD, PhD ;   Marley Greenberg   ⁶ , MA ;   Meranda Nakhla   ^{7, 8, 9} , MSc, MD ;   Ian Zenlea   ^{1, 10, 11} , MD, MPH ;   Elise Mok   ¹² , PhD ;   Jessica C Kichler   ¹³ , CDCES, CPsych, PhD ;   Ellen B Goldbloom   ^{14, 15, 16} , MD ;   Gillian L Booth   ^{10, 11, 17} , MSc, MD ;   Mélanie Henderson   ^{18, 19, 20} , MD, PhD ;   Rayzel Shulman   ^{2, 10, 11, 21 *} , MD, PhD ;   Laura Desveaux   ^{1, 11 *} , PT, PhD

¹ Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada

² Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada

³ Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada

⁴ CDE Oak Valley Health, Markham, ON, Canada

⁵ School of Human Nutrition, McGill University, Montreal, QC, Canada

⁶ Diabetes Action Canada, Canadian Institutes for Health Research (CIHR) Strategy for Patient-Oriented Research Network in Chronic Disease, Toronto General Hospital, Toronto, ON, Canada

⁷ McGill University, Montreal Children’s Hospital, Montreal, QC, Canada

⁸ Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada

⁹ Research Institute of the McGill University Health Centre, Montreal, QC, Canada

¹⁰ Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

¹¹ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

¹² Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada

¹³ Department of Psychology, University of Windsor, Windsor, ON, Canada

¹⁴ Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

¹⁵ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada

¹⁶ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

¹⁷ MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada

¹⁸ Department of Pediatrics, Université de Montréal, Montreal, QC, Canada

¹⁹ Centre de Recherche CHU Sainte-Justine, Montreal, QC, Canada

²⁰ Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada

²¹ Child Health Evaluative Sciences, Sickkids Research Institute, Toronto, ON, Canada

*these authors contributed equally