Transforming Practice: Co-Creating Practitioner Training to Challenge Stigma and Support Activity with Type 1 Diabetes

About the Project

People with Type 1 diabetes (T1D) consistently report a strong desire to participate in physical activity (PA), yet face persistent structural, educational, and interpersonal barriers throughout their lives. Evidence demonstrates that PA is highly beneficial for glycaemic management, psychological wellbeing, and long-term health (Riddell & Peters, 2023), but participation remains disproportionately low due to fears of hypoglycaemia, technological challenges, stigma, and the lack of informed support from teachers, coaches, and fitness professionals (Brazeau et al., 2018; Kennedy et al., 2018).

A national study exploring PA experiences across the life course in people with T1D (Richardson et al., in press) reinforces these issues at scale, showing that misunderstanding, stigma, and ill-informed comments from PA providers constitute a “golden thread” of exclusion from childhood through older adulthood. Participants described educators and coaches who were unsure how to support glucose monitoring, restricted participation unnecessarily, or inadvertently reinforced internalised ableism—often discouraging lifelong engagement in PA.

Currently, PA professionals receive little or no mandatory training on T1D, despite functioning as key gatekeepers of safe, inclusive, and empowering activity environments. This mismatch between the strong desire of people with T1D to be active and the limited knowledge, confidence, and preparedness of PA providers represents a significant gap in policy, practice, and public health guidance. Existing research demonstrates that targeted education for teachers and coaches can significantly improve safety, motivation, and PA participation (Kilbride et al., 2011; Brazeau et al., 2014), yet such training is rarely co-produced with those directly affected.

This PhD aims to co-produce, implement, and evaluate education and training resources that equip PA providers to support safe, inclusive, and empowering participation for people living with T1D. The research will address the following questions:

1. What knowledge, attitudes, and current practices do physical activity providers (teachers, coaches, fitness instructors) hold in relation to supporting people with T1D?
2. What do people living with T1D identify as the essential components of effective provider education, and how can these be translated into accessible training resources?
3. What is the impact of co-produced training on provider confidence, knowledge, and practice, and on the participation experiences of people with T1D?

This research will adopt a Participatory Action Research (PAR) approach, ensuring that people living with T1D are not merely participants but active collaborators in shaping the research process and its outputs. PAR is particularly suited to this project given its emphasis on co-production, its capacity to challenge traditional researcherparticipant hierarchies, and its orientation towards actionable, real-world change (Bergold & Thomas, 2012).

The study will proceed through iterative cycles of inquiry, action, and reflection, working alongside a co-researcher group of people with T1D to develop, pilot, and refine training resources in dialogue with PA providers. The research will be theoretically grounded in critical ableism studies. Ableism refers to the network of beliefs, practices, and structures that privilege certain bodies and minds as "normal" while devaluing and marginalising those deemed deficient or dependent (Campbell, 2009; Goodley, 2014).

Supervisory Team

• Director of Studies: Dr Emma Richardson, Senior Research Fellow
• Supervisors: Prof. Dez Kyte Prof. Győző Molnár

Research Group: Adapted Physical Activity Research Unit

Application Process

To begin the application process please go to: https://www.worc.ac.uk/research/research-degrees/applying-for-a-phd/.

The Interview
All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Doctoral School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

Funding your PhD
For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/feesand-finance/doctoral-loans.aspx

During your PhD you can access the Research Conference Support Scheme to support the costs of presenting your research at an external conference.

For further information or an informal discussion on this project, please contact Dr Emma Richardson; e.richardson@worc.ac.uk