Seeing Is Believing: Using Skype to Improve Diabetes Outcomes in Youth

Abstract

OBJECTIVEThe objective of this study was to compare the relative effectiveness of two modes of delivering Behavioral Family Systems Therapy for Diabetes (BFST-D) to improve adherence and glycemic control among adolescents with type 1 diabetes with suboptimal glycemic control (HbA 1c ‡9.0% [ ‡74.9 mmol/mol]): face to face in clinic (Clinic) and Internet videoconferencing (Skype) conditions. RESEARCH DESIGN AND METHODSAdolescents aged 12 to 18 years and at least one adult caregiver were randomized to receive BFST-D via the Clinic or Skype condition. Participants completed up to 10 therapy sessions within a 12-week period. Changes in youth-and parentreported adherence and glycemic control were compared before and after the intervention and at follow-up assessment. RESULTSUsing an intent-to-treat analytic approach, no significant between-group differences were identified between the before, after, and follow-up assessments. Groups were collapsed to examine the overall effects of BFST-D on adherence and glycemic control. Results identified that statistically significant improvements in adherence and glycemic control occurred from before to after the intervention; improvements were maintained at 3-month follow-up. CONCLUSIONSDelivery of BFST-D via Internet-based videoconferencing is viable for addressing nonadherence and suboptimal glycemic control in adolescents with type 1 diabetes, potentially reducing important barriers to care for youth and families.

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

“…114 Adherence to treatment and glycaemic control were also similar. 91 However, losses to follow-up were high: of the 47 (out of 92) participants randomised to Skype sessions, follow-up data were available for only 32.…”

“…[88][89][90][91][92][93][94][95][96][97][98] A number of published studies focus broadly on video or remote consulting (e.g. exploring issues of usability and acceptability).…”

“…exploring issues of usability and acceptability). 45,[99][100][101][102][103][104][105][106][107][108][109][110][111][112][113] Many focus specifically on the clinical use of Skype, 91,[114][115][116][117][118][119][120][121][122][123] either on its own or in combination with other technologies [e.g. WhatsApp (WhatsApp Inc., Mountain View, CA, USA) messaging 124 or FaceTime 125,126 ].…”

Supporting health-related parenting: A scoping review of programs assisted by the Internet and related technologies

“…Specialized healthcare professionals provide specific education, counseling, and monitoring concerning difficult parenting tasks or problems. Harris, Freeman, and Duke (2015), for example, used a structured parent and adolescent training program through scheduled Skype calls with a psychologist to improve diabetes outcome in youth.…”

Technology-Enhanced Consultations in Diabetes, Cancer, and Heart Failure: Protocol for the Qualitative Analysis of Remote Consultations (QuARC) Project (Preprint)

“…Across these studies, despite reported benefits (e.g. in terms of increased access for patients [9,[28][29][30] particularly those with complex needs, [31] patient and clinician satisfaction with the remote option, [23,[32][33][34][35] potential time/cost savings, [8,36,37] improvement in self-management skills, [38] and improved compliance to treatment and/or clinical outcomes [17,22,24,31,[39][40][41][42][43]) small sample sizes (e.g. five patients) and high losses to follow-up prevent any unqualified conclusion that remote consultations are 'effective'.…”