Internet Psycho-Education Programs Improve Outcomes in Youth With Type 1 Diabetes

Abstract

OBJECTIVEThe purpose of this study was to determine the efficacy of two Internet-based psycho-educational programs designed to improve outcomes for youth with type 1 diabetes transitioning to adolescence.RESEARCH DESIGN AND METHODSThe study was a multisite clinical trial of 320 youth (aged 11–14 years; 37% minority; 55% female) randomized to one of two Internet-based interventions: TeenCope or Managing Diabetes. Primary outcomes were HbA1c and quality of life (QOL). Secondary outcomes included coping, self-efficacy, social competence, self-management, and family conflict. Data were collected at baseline and after 3, 6, and 12 months online. Youth were invited to cross over to the other program after 12 months, and follow-up data were collected at 18 months. Analyses were based on mixed models using intent-to-treat and per-protocol procedures.RESULTSYouth in both groups had stable QOL and minimal increases in HbA1c levels over 12 months, but there were no significant differences between the groups in primary outcomes. After 18 months, youth who completed both programs had lower HbA1c (P = 0.04); higher QOL (P = 0.02), social acceptance (P = 0.01), and self-efficacy (P = 0.03) and lower perceived stress (P = 0.02) and diabetes family conflict (P = 0.02) compared with those who completed only one program.CONCLUSIONSInternet interventions for youth with type 1 diabetes transitioning to adolescence result in improved outcomes, but completion of both programs was better than only one, suggesting that these youth need both diabetes management education and behavioral interventions. Delivering these programs via the Internet represents an efficient way to reach youth and improve outcomes.

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

“…En cualquier caso, los adolescentes con DMT1 deben tomar responsabilidades en el manejo de su enfermedad, pero siempre con el apoyo de su familia, para así tener una buena transición a la atención adulta 45 . Un ejemplo de esto son las intervenciones TEENCOPE (programa de capacitación en habilidades para hacer frente a la diabetes) y Managing Diabetes (programa de educación sobre la diabetes) 37,48 . Ambas intervenciones obtuvieron buenos resultados en cuanto a mejoría de puntuación de Calidad de Vida y una leve mejoría en los niveles de HbA1c 48 .…”

“…Un ejemplo de esto son las intervenciones TEENCOPE (programa de capacitación en habilidades para hacer frente a la diabetes) y Managing Diabetes (programa de educación sobre la diabetes) 37,48 . Ambas intervenciones obtuvieron buenos resultados en cuanto a mejoría de puntuación de Calidad de Vida y una leve mejoría en los niveles de HbA1c 48 . También destaca el estudio CASCADE (Enfoque de Competencias Estructuradas de Niños y Adolescentes para la Educación sobre la Diabetes), programa educativo grupal estructurado y basado en la clínica que incorpora enfoques psicológicos con la finalidad de mejorar el control glucémico a largo plazo, la calidad de vida y el funcionamiento psicosocial en una amplia gama de niños, niñas y adolescentes diabéticos.…”

Depressive Symptoms in a Trial Behavioral Family Systems Therapy for Diabetes: A Post Hoc Analysis of Change

“…†Statistically significant mean difference from the posttreatment score at P , 0.05. important practical implications and underscores the need for dissemination of family-based interventions for adolescents with diabetes such as BFST-D. The formats of these interventions may be clinic based (15,16,(31)(32)(33) or online (20,34,35). Additionally important is identifying adolescents with diabetes who are at risk for depression.…”

“…Additionally important is identifying adolescents with diabetes who are at risk for depression. The American Academy of Pediatrics now endorses depression screening for all adolescents (34), and this is especially important for youth with diabetes given the impact on physical health. With earlier and better identification, psychosocial interventions like BFST-D hold potential to prevent undesirable health outcomes.…”

Diabetes Mellitus

“…For example, several researchers in the TEENCOPE study group examined the effectiveness of two internet interventions for youth with type 1 diabetes (Grey et al, 2013 ). Participants were between the ages of 11 and 14 years.…”