School‐aged children with type 1 diabetes benefit more from a coping skills training program than adolescents in China: 12‐month outcomes of a randomized clinical trial

Abstract

Background: Managing type 1 diabetes can be challenging, especially for youth, so there is a need for effective interventions to help youth live with diabetes.Objective: To determine the efficacy of a coping skills training (CST) program for Chinese youth with type 1 diabetes and to explore whether the efficacy of the program was different for school-aged children than for adolescents with type 1 diabetes.Methods: A total of 100 youth with type 1 diabetes aged 8 to 20 years were randomly placed in either an intervention group (CST + standard care [SC]) or a control group (SC). Data were collected at baseline, 6-month, and 12-month follow-ups on primary outcomes of perceived stress, coping, and self-efficacy and secondary outcomes of diabetes self-management, quality of life, and glycated hemoglobin A1c (HbA1c). A generalized estimating equation analysis for repeated measures was used to determine the program effects and differential effects by age group.Results: The CST program had no significant effect on primary or secondary outcomes over 12 months. However, there was a significant increase in positive coping (P < .001), self-efficacy (P = .017), diabetes problem-solving and goals of diabetes self-management (P = .007, P = .001), and quality of life (P = .016) of school-aged children in the intervention group compared with the control group. There were no significant differences in primary or secondary outcomes between the intervention group and the control group (P > .05). Conclusions:The CST program was effective for school-aged children, improving psychosocial and diabetes self-management outcomes. Further research is needed to develop programs that improve outcomes in adolescents with type 1 diabetes.

The Effects of Diabetes Self-Management Education on Quality of Life for Persons With Type 1 Diabetes: A Systematic Review of Randomized Controlled Trials

“…Pyatek et al 58 did not distinguish QoL outcomes by diabetes type; therefore, these results were not included in this portion of the review. Guo et al 60 reported significant increases in the QoL outcomes in a school-age intervention cohort of children with T1DM ( P = .016) but did not observe these effects in adolescents. Mayer-Davis et al, 63 demonstrated greater increases in self-reported QoL by adolescents in the intervention group compared to the control ( P = .009).…”

“…Participants allocated to control groups in most retained reports received usual or standardized care (n =14), 43 -45,53 -56,60 -62,63,65 -67 which typically consisted of routine visits with health care providers every 3 months. However, as opposed to usual care, the remaining 5 studies used a waiting list control group (n = 1), 64 control groups receiving diabetes education (n = 2), 59,68 or attention control groups (n = 2).…”

“…In the remaining 10 studies (12 reports), QoL was described as a secondary outcome. 44,54,55,57,58,60 -63,65,67,69 Only 3 studies 60,63,67 described significant improvements in QoL measures for people with T1DM. Pyatek et al 58 did not distinguish QoL outcomes by diabetes type; therefore, these results were not included in this portion of the review.…”

“…Studies with pediatric populations utilized age-specific instruments. Four studies reported significant improvements in QoL through generic tools 43,56,60,63 and the remaining 3 through diabetes-specific measures. 53,67,68 Of the studies that reported significant improvements in QoL, 2 targeted adult populations, 67,68 whereas 5 included school-age children or adolescents and proxy report of child QoL by a family caregiver.…”

Parent–Child Relationship Quality as a Mediator of the Association between Perceived Stress and Diabetes Self-Management in Adolescents With Type 1 Diabetes

“…The study group comprised 122 adolescents who were recruited as part of baseline assessment in a randomized controlled trial designed to assess the efficacy of a coping skills training program for Chinese adolescents with T1D (Guo et al, 2020). The eligibility requirements for enrollment were as follows: aged 10-18 years, diagnosed with T1D and receiving insulin treatment for at least 6 months, and the ability to speak and write Chinese.…”