1
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Omidvar Eshkalak Z, Parvizy S, Seyedfatemi N, Haghani H, Nazari H. The effectiveness of web-based training for parents on post-traumatic stress disorder in children. Front Psychol 2024; 15:1325475. [PMID: 38605831 PMCID: PMC11008461 DOI: 10.3389/fpsyg.2024.1325475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/13/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Post-traumatic stress disorder (PTSD) after an injury such as accidents is common in children and can affect their overall physical and mental functioning and quality of life. Early intervention can have significant health benefits for children. This study aimed to investigate the effectiveness of web-based training for parents on post-traumatic stress disorder in children. Method This was a quasi-experimental study with intervention and control group. 110 parents of children aged 10-18 years with PTSD after a traumatic event were selected through available sampling and assigned to intervention and control groups. Data was collected by a researcher-made demographic questionnaire and the Child Revised Impact of Events Scale (CRIES-8). Parents in the intervention group received a 4-week training course through a researcher-designed website, but the control group received routine care by the clinical team, which the main focus of care and training was on the physical aspects of the disease, and no intervention was done for PTSD. Two weeks after the intervention, the level of child stress was measured and compared in both groups. Data were analyzed using SPSS V.22. Results The difference between the mean score of total traumatic stress and its subscales before intervention was not statistically significant (p = 0.23). But after intervention, the mean score of total traumatic stress and its subscales decreased in the intervention group and increased in the control group and this difference was statistically significant (p < 0.001). Conclusion E-learning parent training has the potential to support children with PTSD. This available and cost-effective procedure can be recommended to help children with PTSD and possibly increase recovery in these patients.
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Affiliation(s)
| | - Soroor Parvizy
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Nazari
- Department of Pediatric Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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2
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Singh P, Otero JM, Howe C, Feinstein RT, Gupta K, Gladstone TRG, Van Voorhees BW, Gupta OT. Internet-based cognitive behavioral therapy intervention for youth with type 1 diabetes and depressive symptoms: a pilot and feasibility study. Mhealth 2023; 10:6. [PMID: 38323145 PMCID: PMC10839524 DOI: 10.21037/mhealth-23-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/24/2023] [Indexed: 02/08/2024] Open
Abstract
Depression is more common in youth with type 1 diabetes (T1D) compared to youth without diabetes. This study aims to assess the efficacy of Competent Adulthood Transition with Cognitive Humanistic and Interpersonal Teaching (CATCH-IT), an internet-based cognitive behavioral therapy (CBT) intervention, in adolescents with T1D and depressive symptoms. Adolescents (13 to 17 years old) with T1D and mild (score 5-9) or moderate (score 10-14) depressive symptoms on Patient Health Questionnaire-Adolescent (PHQ-A) screening assessment were recruited to participate and received online access to the CATCH-IT modules for 6 months (requested to complete in 12 weeks). Statistical analyses included paired t-test for changes in Center for Epidemiologic Studies Depression Scale (CES-D), PHQ-A, Problem Areas in Diabetes-Teen version (PAID-T), and hemoglobin A1c (HbA1c). Nineteen patients were consented, 15 met inclusion criteria and received the intervention. In the seven participants that completed the modules, there was a trend towards improvements in PHQ-A, CES-D and HbA1c. Participants provided robust qualitative feedback on the modules and areas for improvement in subsequent iterations, such as inclusion of diabetes-related content. Given the prevalence of depression in diabetes, feasible, low resource interventions are needed. Internet programs such as CATCH-IT can serve as an effective first line intervention in this high-risk population. A modified version of CATCH-IT tailored for adolescents with T1D may be beneficial in this patient population.
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Affiliation(s)
- Puja Singh
- Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA
| | - Juan Mejia Otero
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Carol Howe
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, USA
| | | | - Kushagra Gupta
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Tracy R. G. Gladstone
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | | | - Olga T. Gupta
- Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA
- Division of Pediatric Endocrinology, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
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3
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LeStourgeon L, Bergner E, Datye K, Streisand R, Jaser S. Evaluation of Study Engagement With an mHealth Intervention (THR1VE) to Treat Diabetes Distress in Teens With Type 1 Diabetes: Randomized Clinical Trial. JMIR Pediatr Parent 2023; 6:e47089. [PMID: 37800881 PMCID: PMC10594399 DOI: 10.2196/47089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/06/2023] [Accepted: 07/13/2023] [Indexed: 10/07/2023] Open
Abstract
Background Positive psychology interventions demonstrate improvements in diabetes self-management and quality of life among adults with chronic health conditions, but few interventions for adolescents use this approach. Objective This study describes engagement with a positive psychology intervention delivered via automated SMS text messages aimed at treating diabetes distress and improving diabetes outcomes. In addition, demographic and clinical predictors of intervention engagement were examined. Methods Adolescents with type 1 diabetes (ages 13-17 years) who reported at least moderate diabetes distress were randomized to receive either the education or positive affect + education intervention, comprising 8 weeks of automated SMS text messages. Engagement was assessed as the response to the SMS text messages. Adolescents completed satisfaction surveys 3 months post intervention, and a subset of participants from both intervention groups completed exit interviews. Results Adolescents in both groups reported high levels of satisfaction with the study, with 95% (163/172) reporting that they would participate again. Engagement with the SMS text messages was high; on average, adolescents in the positive affect + education group responded to 92.5% of intervention messages, and their caregivers responded to 88.5% of messages. There were no significant differences in rates of engagement related to adolescents' sex, age, device use, or race/ethnicity. Conclusions A positive psychology intervention for adolescents delivered via automated SMS text messages was feasible and acceptable across genders, ages, and racial/ethnic groups, suggesting potential for wider dissemination.
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Affiliation(s)
- Lauren LeStourgeon
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Erin Bergner
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Karishma Datye
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Randi Streisand
- Department of Pyschology and Behavioral Health, Children's National Hospital, WashingtonDC, United States
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, WashingtonDC, United States
| | - Sarah Jaser
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
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4
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Wang R, Rouleau G, Booth GL, Brazeau AS, El-Dassouki N, Taylor M, Cafazzo JA, Greenberg M, Nakhla M, Shulman R, Desveaux L. Understanding Whether and How a Digital Health Intervention Improves Transition Care for Emerging Adults Living With Type 1 Diabetes: Protocol for a Mixed Methods Realist Evaluation. JMIR Res Protoc 2023; 12:e46115. [PMID: 37703070 PMCID: PMC10534286 DOI: 10.2196/46115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/27/2023] [Accepted: 07/24/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Emerging adults living with type 1 diabetes (T1D) face a series of challenges with self-management and decreased health system engagement, leading to an increased risk of acute complications and hospital admissions. Effective and scalable strategies are needed to support this population to transfer seamlessly from pediatric to adult care with sufficient self-management capability. While digital health interventions for T1D self-management are a promising strategy, it remains unclear which elements work, how, and for which groups of individuals. OBJECTIVE This study aims to evaluate the design and implementation of a multicomponent SMS text message-based digital health intervention to support emerging adults living with T1D in real-world settings. The objectives are to identify the intervention components and associated mechanisms that support user engagement and T1D health care transition experiences and determine the individual characteristics that influence the implementation process. METHODS We used a realist evaluation embedded alongside a randomized controlled trial, which uses a sequential mixed methods design to analyze data from multiple sources, including intervention usage data, patient-reported outcomes, and realist interviews. In step 1, we conducted a document analysis to develop a program theory that outlines the hypothesized relationships among "individual-level contextual factors, intervention components and features, mechanisms, and outcomes," with special attention paid to user engagement. Among them, intervention components and features depict 10 core characteristics such as transition support information, problem-solving information, and real-time interactivity. The proximal outcomes of interest include user engagement, self-efficacy, and negative emotions, whereas the distal outcomes of interest include transition readiness, self-blood glucose monitoring behaviors, and blood glucose. In step 2, we plan to conduct semistructured realist interviews with the randomized controlled trial's intervention-arm participants to test the hypothesized "context-intervention-mechanism-outcome" configurations. In step 3, we plan to triangulate all sources of data using a coincidence analysis to identify the necessary combinations of factors that determine whether and how the desired outcomes are achieved and use these insights to consolidate the program theory. RESULTS For step 1 analysis, we have developed the initial program theory and the corresponding data collection plan. For step 2 analysis, participant enrollment for the randomized controlled trial started in January 2023. Participant enrollment for this realist evaluation was anticipated to start in July 2023 and continue until we reached thematic saturation or achieved informational power. CONCLUSIONS Beyond contributing to knowledge on the multiple pathways that lead to successful engagement with a digital health intervention as well as target outcomes in T1D care transitions, embedding the realist evaluation alongside the trial may inform real-time intervention refinement to improve user engagement and transition experiences. The knowledge gained from this study may inform the design, implementation, and evaluation of future digital health interventions that aim to improve transition experiences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46115.
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Affiliation(s)
- Ruoxi Wang
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Geneviève Rouleau
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Département des Sciences Infirmières, Université du Québec en Outaouais, St-Jérôme, QC, Canada
- Faculté des sciences infirmières, l'Université de Montréal, Montreal, QC, Canada
| | - Gillian Lynn Booth
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Noor El-Dassouki
- Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Madison Taylor
- Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Joseph A Cafazzo
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Marley Greenberg
- Department of Philosophy, Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
- Diabetes Action Canada, Toronto, ON, Canada
| | - Meranda Nakhla
- Division of Endocrinology, Montreal Children's Hospital, McGill University, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Rayzel Shulman
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Laura Desveaux
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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5
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Boehm LM, Danesh V, LaNoue M, Trochez RJ, Jones AC, Kimpel CC, Sevin CM. Factors Influencing Engagement with in-Person Intensive Care Unit Recovery Clinic Services. J Intensive Care Med 2023; 38:375-381. [PMID: 36128790 PMCID: PMC9991933 DOI: 10.1177/08850666221127154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Intensive Care Unit recovery clinics (ICU-RC), are multidisciplinary outpatient clinics designed to identify and treat post-intensive care syndrome impairments unique to each survivor of critical illness. Engagement is limited, thus we aimed to describe patient- and hospitalization-related sociodemographic factors associated with scheduling and attending in-person ICU-RC visits. Design: Consecutive case series of prospectively collected ICU-RC referral data. Setting: Data was collected over a 9-year period (2012-2020) for patients referred to an ICU-RC from ICUs at an academic medical center in the southeast United States. Participants: 251 adults admitted to a medical, surgical, burn, or trauma ICU referred to the ICU-RC and eligible to be scheduled for a visit. Main Outcome and Measures: The main study outcome was scheduling and completing an ICU-RC visit. Independent variables included patient demographics, ICU visit characteristics (eg, diagnosis, ventilator days), severity of illness, discharge disposition, ICU-RC referral criteria (eg, shock, delirium), and clinic scheduling administrative data (eg, referral date, clinic visit date). Results: Of 251 ICU-RC referrals eligible for a visit, 128 were scheduled, and 91 completed a visit. In univariate models older age, unspecified shock, and distance from the clinic location were associated with decreased in-person ICU-RC engagement. In a multivariable logistic regression using the same predictors and interactions, older age, unspecified shock, and home-to-clinic distance remained as factors decreasing the likelihood of ICU-RC engagement. There was a decreasing likelihood of scheduling and attending an ICU-RC visit for every additional mile of distance the patient lived from the ICU-RC. Male sex was a strong predictor of completing an ICU-RC visit. Conclusions: Older ICU survivors and those who live farther from the clinic site are less likely to engage in an in-person ICU-RC. Innovation and telemedicine strategies are needed to improve access to ICU recovery care for these populations.
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Affiliation(s)
- Leanne M Boehm
- Vanderbilt University School of Nursing, Nashville, TN, USA.,Critical Illness, Brain dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Valerie Danesh
- Center for Applied Health Research, 423342Baylor Scott & White Health, Dallas, TX, USA
| | | | - Ricardo J Trochez
- Center for Clinical Quality and Implementation Research, 5718Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Christine C Kimpel
- Vanderbilt University School of Nursing, Nashville, TN, USA.,Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Carla M Sevin
- Critical Illness, Brain dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Medicine, 12328Vanderbilt University Medical Center, Nashville, TN, USA
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6
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Wu Y, Zhang YY, Zhang YT, Zhang HJ, Long TX, Zhang Q, Huang J, Li MZ. Effectiveness of resilience-promoting interventions in adolescents with diabetes mellitus: a systematic review and meta-analysis. World J Pediatr 2023; 19:323-339. [PMID: 36534296 PMCID: PMC9761642 DOI: 10.1007/s12519-022-00666-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND This study aimed to analyze the efficacy of resilience-promoting interventions among adolescents and youth aged 10-24 years with any type of diabetes. METHODS A systematic literature search was performed using the PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and PsycINFO databases from inception to May 25, 2022. The Cochrane risk of bias tool (version 2) was used to assess the quality of the included studies. A meta-analysis was performed to calculate the pooled effects of resilience-promoting interventions. RESULTS Nineteen articles were included covering an overall sample of 2048 adolescents with diabetes. When analyzing the effectiveness of resilience-promoting interventions, hemoglobin A1c (HbA1c) at six months [mean difference = - 0.47, 95% confidence interval (CI) = - 0.83 to - 0.12, P = 0.009] after the intervention was improved. However, long-term (≥ 12 months) improvement in HbA1c was not significant. In addition, comparing the control group, there were significant differences in the effect size for stress [standardized mean difference (SMD) = - 0.87, 95% CI = - 1.25 to -0.48, P < 0.05], self-efficacy (SMD = 0.50, 95% CI = 0.02-0.98, P = 0.04) and quality of life (SMD = 0.27, 95% CI = 0.03-0.51, P = 0.03). CONCLUSIONS Resilience-promoting intervention is a promising way for adolescent diabetes management to improve HbA1c, stress, self-efficacy, and quality of life. Incorporating resilience-promoting components into diabetes education and re-enforcing these contents every six months are recommended for implementation in clinical practice.
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Affiliation(s)
- Yi Wu
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Yi-Yun Zhang
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Ya-Ting Zhang
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China
| | | | - Tian-Xue Long
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Qi Zhang
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Jing Huang
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Ming-Zi Li
- Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing, 100191, China.
- School of Nursing, Peking University, Beijing, China.
- Peking University Health Science Centre for Evidence-Based Nursing, A Joanna Briggs Institute Affiliated Group, Beijing, China.
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7
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Delamater AM. Forty Years of Behavioral Diabetes Research: A Personal Journey. Diabetes Spectr 2023; 36:88-96. [PMID: 36818415 PMCID: PMC9935293 DOI: 10.2337/ds22-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article was adapted from the address Dr. Delamater delivered as the recipient of the American Diabetes Association's Richard R. Rubin Award for 2022. This award recognizes a behavioral researcher who has made outstanding, innovative contributions to the study and understanding of the behavioral aspects of diabetes in diverse populations. Dr. Delamater delivered the address in June 2022 at the Association's virtual 82nd Scientific Sessions. A webcast of this speech is available for viewing on the DiabetesPro website (https://professional.diabetes.org/webcast/stigma-diabetes-care%E2%80%94evidence-and-solutions-richard-r-rubin-award-lecture).
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8
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Lindholm Olinder A, DeAbreu M, Greene S, Haugstvedt A, Lange K, Majaliwa ES, Pais V, Pelicand J, Town M, Mahmud FH. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes education in children and adolescents. Pediatr Diabetes 2022; 23:1229-1242. [PMID: 36120721 PMCID: PMC10107631 DOI: 10.1111/pedi.13418] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 12/29/2022] Open
Affiliation(s)
- Anna Lindholm Olinder
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.,Sachs' Children and Youths Hospital, Södersjukhuset, Stockholm, Sverige
| | - Matthew DeAbreu
- Parent and Advocate of Child with Type One Diabetes, Toronto, Ontario, Canada
| | | | - Anne Haugstvedt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Edna S Majaliwa
- Department of Paediatrics and child health, Muhimbili National Hospital, Dar es Salaam, Tanzania.,Departement of peadiatrics and child health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Vanita Pais
- Department of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Julie Pelicand
- Pediatric Diabetology Unit, San Camilo Hospital, Medicine School, Universidad de Valparaiso, San Felipe, Chile.,Childhood, Adolescence & Diabetes, Toulouse Hospital, Toulouse, France
| | - Marissa Town
- Children with Diabetes and Department of Pediatric Endocrinology, Stanford University, California, USA
| | - Farid H Mahmud
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada
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9
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de Wit M, Gajewska KA, Goethals ER, McDarby V, Zhao X, Hapunda G, Delamater AM, DiMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes. Pediatr Diabetes 2022; 23:1373-1389. [PMID: 36464988 PMCID: PMC10107478 DOI: 10.1111/pedi.13428] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, Netherlands
| | - Katarzyna A Gajewska
- Diabetes Ireland, Dublin, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Given Hapunda
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Linda A DiMeglio
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
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10
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Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F. The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:10-69. [PMID: 37522807 PMCID: PMC10408697 DOI: 10.1080/19585969.2022.2134739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. METHODS An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. RESULTS Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. CONCLUSIONS An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joshua Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Leo Malandain
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, University of Paris Cité, Paris, France
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11
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Holder M, Kapellen T, Ziegler R, Bürger-Büsing J, Danne T, Dost A, Holl RW, Holterhus PM, Karges B, Kordonouri O, Lange K, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Neu A. Diagnosis, Therapy and Follow-Up of Diabetes Mellitus in Children and Adolescents. Exp Clin Endocrinol Diabetes 2022; 130:S49-S79. [PMID: 35913059 DOI: 10.1055/a-1624-3388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Martin Holder
- Klinikum Stuttgart, Olgahospital, Department of Pediatric Endocrinology and Diabetology, Germany
| | - Thomas Kapellen
- Department of Paediatrics and Adolescent Medicine, University Hospital, Leipzig, Germany
| | - Ralph Ziegler
- Practice for Paediatrics and Adolescent Medicine, Focus on Diabetology, Münster, Germany
| | - Jutta Bürger-Büsing
- Association of Diabetic Children and Adolescents, Diabetes Center, Kaiserslautern, Germany
| | - Thomas Danne
- Children's and Youth Hospital Auf der Bult, Hannover, Germany
| | - Axel Dost
- Department of Paediatrics and Adolescent Medicine, University Hospital Jena, Germany
| | - Reinhard W Holl
- Institute for Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany
| | - Paul-Martin Holterhus
- Department of General Paediatrics, University Hospital Schleswig-Holstein, Kiel Campus, Germany
| | - Beate Karges
- Endocrinology and Diabetology Section, University Hospital, RWTH Aachen University, Germany
| | - Olga Kordonouri
- Children's and Youth Hospital Auf der Bult, Hannover, Germany
| | - Karin Lange
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | | | - Klemens Raile
- Virchow Hospital, University Medicine, Berlin, Germany
| | - Roland Schweizer
- Department of Pediatrics and Adolescent Medicine, University Hospital Tübingen, Germany
| | - Simone von Sengbusch
- Department of Paediatrics and Adolescent Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Rainer Stachow
- Sylt Specialist Hospital for Children and Adolescents, Westerland, Germany
| | - Verena Wagner
- Joint Practice for Paediatrics and Adolescent Medicine, Rostock, Germany
| | | | - Andreas Neu
- Department of Pediatrics and Adolescent Medicine, University Hospital Tübingen, Germany
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12
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Signore AK, Jung ME, Semenchuk B, Kullman SM, Tefft O, Webber S, Ferguson LJ, Kowalski K, Fortier M, McGavock J, Ahmed R, Orr M, Strachan S. A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes. Pilot Feasibility Stud 2022; 8:111. [PMID: 35624519 PMCID: PMC9135984 DOI: 10.1186/s40814-022-01072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. METHODS This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). RESULTS Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. CONCLUSION The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). TRIAL REGISTRATION ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.
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Affiliation(s)
- Alana K Signore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Brittany Semenchuk
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Sasha M Kullman
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Olivia Tefft
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Webber
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Kent Kowalski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Michelle Fortier
- School of Human Kinetics, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jon McGavock
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Rashid Ahmed
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Marion Orr
- Inner Compass Counselling, Winnipeg, MB, R3G 2X6, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
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13
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Garner K, Boggiss A, Jefferies C, Serlachius A. Digital health interventions for improving mental health outcomes and wellbeing for youth with type 1 diabetes: A systematic review. Pediatr Diabetes 2022; 23:258-269. [PMID: 34913548 DOI: 10.1111/pedi.13304] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/04/2021] [Accepted: 12/09/2021] [Indexed: 01/20/2023] Open
Abstract
Digital health interventions are a promising alternative to face-to-face psychosocial interventions that may improve psychological outcomes in youth with diabetes. Several reviews have explored the efficacy of digital health interventions for adults and youth with some chronic health conditions; however, their efficacy among youth with type 1 diabetes is not known. This systematic review aims to assess digital health interventions targeting both psychological and physical health outcomes in youth with type 1 diabetes as well as to evaluate study quality and efficacy, and provide directions for future research in this area. Relevant studies were identified through searches conducted in MEDLINE, Embase, APA PsycInfo, Scopus, Cochrane Central, and CINAHL Plus up until February 2021. Studies were included if they were randomized; reported at least one psychological outcome that was assessed at ≥2 time points; included a digital health intervention; and were conducted in youth aged 5 to 25 years with type 1 diabetes. The revised Cochrane risk-of-bias (RoB 2) tool was used to assess risk of bias. Of the 5159 articles found, 15 met the inclusion criteria and were included in the review. Self-efficacy improved in 2 of the 3 studies which assessed self-efficacy; however, no consistent improvements were found for other psychological, behavioral, or physical outcomes. All studies showed some risk of bias concerns. More research is needed to make firm conclusions on the efficacy of digital health interventions for youth with diabetes. More specifically, interventions based on psychological theories are needed and studies of higher quality methodologies.
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Affiliation(s)
- Katie Garner
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Anna Boggiss
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Craig Jefferies
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Anna Serlachius
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
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14
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O’Donnell NR, Satherley RM, John M, Cooke D, Hale LS, Stewart R, Jones CJ. Development and Theoretical Underpinnings of the PRIORITY Intervention: A Parenting Intervention to Prevent Disordered Eating in Children and Young People With Type 1 Diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:822233. [PMID: 36992722 PMCID: PMC10012129 DOI: 10.3389/fcdhc.2022.822233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022]
Abstract
Children and young people (CYP) with type 1 diabetes (T1D) are twice as likely to develop disordered eating (T1DE) and clinical eating disorders than those without. This has significant implications for physical and mental health, with some eating disorders associated with repeated diabetic ketoacidosis and higher HbA1c levels, both of which are life threatening. There is currently limited psychological support for CYP and families with T1D but increasingly, policy and practice are suggesting disordered eating in T1D may be effectively prevented through psychological intervention. We describe the development and theoretical underpinnings of a preventative psychological intervention for parents of CYP aged 11-14, with T1D. The intervention was informed by psychological theory, notably the Information Motivation Behaviour Skills model and Behaviour Change Technique Taxonomy. The intervention was co-developed with an expert advisory group of clinicians, and families with T1D. The manualised intervention includes two online group workshops, and supplementary online materials. The intervention continues to evolve, and feasibility findings will inform how best to align the intervention with routine care in NHS diabetes teams. Early detection and intervention are crucial in preventing T1DE, and it is hoped that the current intervention can contribute to improving the psychological and physical wellbeing of young people and families managing T1D.
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Affiliation(s)
| | | | - Mary John
- School of Psychology, University of Surrey, Guildford, United Kingdom
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton & Hove, United Kingdom
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Lucy S. Hale
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Rose Stewart
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, United Kingdom
| | - Christina J. Jones
- School of Psychology, University of Surrey, Guildford, United Kingdom
- *Correspondence: Christina J. Jones,
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15
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Berkanish P, Pan S, Viola A, Rademaker Q, Devine KA. Technology-Based Peer Support Interventions for Adolescents with Chronic Illness: A Systematic Review. J Clin Psychol Med Settings 2022; 29:911-942. [PMID: 35147830 PMCID: PMC8853345 DOI: 10.1007/s10880-022-09853-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 01/11/2023]
Abstract
Technology may help adolescents with chronic illnesses overcome barriers to accessing peer support, which has been associated with better quality of life and health outcomes. This review aimed to describe technology-based peer support interventions for adolescents with chronic illness following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 3781 articles identified, 32 met inclusion criteria. The most common technologies were websites with discussion forums (n = 18), chat messaging (n = 9), and video conferencing (n = 7). Most studies (69%) focused on feasibility and had small sample sizes. Results support the feasibility and acceptability of these interventions. Results suggested positive effects on social support, but were mixed on isolation, quality of life, and disease self-management. There were too few adequately powered randomized controlled trials to determine efficacy of these interventions at this time. Future work should use rigorous methods to evaluate efficacy and account for rapid shifts in technology for adolescent communication.
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Affiliation(s)
| | - Samuel Pan
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Adrienne Viola
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | | | - Katie A Devine
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. .,Rutgers Cancer Institute of New Jersey and Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA.
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16
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Digital Technologies for Children and Parents Sharing Self-Management in Childhood Chronic or Long-Term Conditions: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121203. [PMID: 34943399 PMCID: PMC8700031 DOI: 10.3390/children8121203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 12/09/2021] [Indexed: 01/20/2023]
Abstract
Worldwide, the prevalence of chronic (or long-term) conditions in children and young people from birth to 18 years (children) is increasing. Promoting competent and effective self-management skills early in the trajectory is important to improve adherence to treatment and optimise quality of life. Successful self-management, therefore, requires parents and children who are developmentally able to develop a range of complex skills, including the use of digital technologies. This scoping review aimed to identify primary research investigating digital technologies for children and parents sharing self-management in childhood chronic illnesses. A comprehensive search of electronic databases was conducted. Nineteen papers were included, assessed for quality and methodological rigour using the Hawker tool and thematically analysed. Three themes were identified: (i) the feasibility and acceptability of using technology, (ii) the usability of technologies and (iii) the effect of technologies on adherence and self-management skills. The results indicate that technologies such as mobile apps and websites can assist the management of long-term conditions, are an acceptable method of delivering information and can promote the development of effective self-management skills by parents and children. However, future technology design must include children and parents in all stages of development.
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17
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Boggiss AL, Consedine NS, Schache KR, Wallace-Boyd K, Cao N, Hofman PL, Serlachius AS. Exploring the views of adolescents with type 1 diabetes on digital mental health interventions: What functionality and content do they want? Diabet Med 2021; 38:e14591. [PMID: 33930211 DOI: 10.1111/dme.14591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Adolescents with type 1 diabetes (T1D) experience higher rates of psychological disorders compared with their healthy peers. As poor psychological health has been associated with suboptimal glycaemic control and more frequent complications, there is an urgent need to develop more 'clinically usable' interventions. Digital mental health interventions offer unique advantages compared with in-person interventions; however, what adolescents with T1D want in terms of content and functionality is poorly understood. Accordingly, the current study conducted focus groups to examine the views of adolescents with T1D regarding digital mental health interventions. METHODS Four focus groups were conducted, including 16 adolescents with T1D, ranging from 13 to 17 years in age (69% female). Transcripts were analysed using directed content analysis to examine (1) 'what adolescents dislike about existing digital mental health interventions?' and (2) 'what adolescents want in future digital mental health interventions?'. RESULTS Findings provide a preliminary understanding of what adolescents dislike and also the type of content and functional features, which may be important to include in digital mental health programs for this population, such as a peer support feature (reported by 16 of 16), emotion and diabetes check-in feature (11 of 16) and diabetes-relevant content (12 of 16). CONCLUSIONS Early data suggest that digital mental health interventions should include a significant peer support element, diabetes-relevant content and examples, and check-in on their mental health and diabetes self-management regularly, while avoiding fixed responses or modules and non-age-appropriate content. Based on these findings, a digital intervention is currently being developed.
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Affiliation(s)
- Anna L Boggiss
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kiralee R Schache
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Psychological Medicine, Counties Manukau Health, Auckland, New Zealand
| | - Kate Wallace-Boyd
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Anna S Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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18
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Zhao X, Hilton A, Watson R, Chen Y. Development and Validity Testing of a Type 1 Diabetes Resource for 10-19-Years Old Adolescents in China. J Pediatr Nurs 2021; 60:e96-e103. [PMID: 33836937 DOI: 10.1016/j.pedn.2021.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This phase 1 study aimed to develop a Type 1 diabetes (T1DM) educational resource for adolescents (10-19 years) in China, and to test its validity for improving diabetes knowledge, self-efficacy and adherence. DESIGN AND METHODS This phase 1 study was carried out in four phases: preliminary development of the Type 1 diabetes educational resource in English based on the health belief model (HBM) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines 2014; translation of the resource into Chinese; readability testing of the resource; and face and content validity testing for scientific and clinical accuracy. RESULTS Type 1 diabetes educational resource with 17 "topics" in four sections was developed for 10-19-years old adolescents in China. Cartoon story, images, stories, questions & answers, and quizzes were used to attract adolescents' interest. Furthermore, the educational resource was confirmed to be understandable among adolescents, clinically accurate, and consistent with its purpose. CONCLUSIONS This resource with good readability and content validity is a potential facilitator for diabetes education and self-management in adolescents with T1DM in China. PRACTICAL IMPLICATIONS This type 1 diabetes resource can be used to educate adolescents with T1DM as a validated resource after further testing in an effectiveness study.
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Affiliation(s)
- Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University, China.
| | | | | | - Yanhua Chen
- The Affiliated Hospital of Southwest Medical University, China.
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19
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Majidi S, Reid MW, Fogel J, Anderson B, Klingensmith GJ, Cain C, Berget C, Raymond JK. Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments. Pediatr Diabetes 2021; 22:787-795. [PMID: 33838078 DOI: 10.1111/pedi.13212] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/20/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school-aged youth. Youth with T1D, 11-13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed-effects models. Eighty-six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the 12-month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p = 0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p = 0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. Participation in Team Clinic was associated with improved psychosocial outcomes in middle school-aged participants with T1D.
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Affiliation(s)
- Shideh Majidi
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mark W Reid
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jennifer Fogel
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Barbara Anderson
- Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA
| | - Georgeanna J Klingensmith
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cindy Cain
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer K Raymond
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
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20
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Bergmame L, Shaw S. Clinical Utility of Psychoeducational Interventions for Youth with Type 1 Diabetes: A Scoping Review. CONTINUITY IN EDUCATION 2021; 2:76-108. [PMID: 38774890 PMCID: PMC11104390 DOI: 10.5334/cie.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/03/2021] [Indexed: 05/24/2024]
Abstract
Adolescence is a challenging time for the medical management of type 1 diabetes. Thus, a range of psychoeducational interventions have been developed to improve diabetes management among youth. Systematic reviews of this literature have emphasized the effectiveness of interventions for improving patient outcomes. However, knowledge beyond what works is required for interventions to be adopted into routine clinical practice. The objective of this scoping review was to map the clinical utility of the literature based on a variety of indicators, including the problem base, context placement, information gain, transparency, pragmatism, and patient-centeredness of the research. This lens for reviewing research is consistent with the biopsychosocial model and an increasing focus on reducing disability, including activity limitation and participation restriction. PsycINFO, MEDLINE, and CINHAL databases were searched for evaluative psychoeducational intervention studies published between January 2005 and October 2020. Two cited reference searches and one reference list search were also performed. Fifty studies describing 46 different interventions were identified. The clinical utility of the interventions was highly variable. A detailed overview of the clinical utility of the literature is provided with an emphasis on current gaps and shortcomings to be addressed in future research. This work helps advance the translation of clinical knowledge into practice in schools, homes, and communities; and, ultimately, improve the health and well-being of adolescents with T1D.
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21
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Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOLOGE 2021. [DOI: 10.1007/s11428-021-00769-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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22
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Schlub GM, Crook A, Barlow-Stewart K, Fleming J, Kirk J, Tucker K, Greening S. Helping young children understand inherited cancer predisposition syndromes using bibliotherapy. J Genet Couns 2021; 30:1119-1132. [PMID: 33788335 DOI: 10.1002/jgc4.1396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/21/2021] [Accepted: 01/31/2021] [Indexed: 12/23/2022]
Abstract
Communication with children about hereditary conditions in the family can be difficult for parents. Yet, good communication strategies are leading determinants of adaptation and resilience. With inherited cancer predisposition syndromes that can affect young children such as Li-Fraumeni syndrome (LFS) and hereditary pheochromocytoma and paraganglioma syndrome (HPPS), genetic testing and subsequent surveillance in at-risk children is the optimal intervention. Given testing often commences early, providing children and their parents with appropriate genetic counseling and communication strategies is important for informed decision making. To inform such communication strategies, we used a bibliotherapeutic framework, where stories are delivered prescriptively (i.e., 'bibliotherapy'), to develop a psycho-educational resource for children aged 5-10 years old at risk of either LFS or HPPS. Illustrated storybooks for children were created based on models of developmental comprehension. To ascertain their experience, parents were invited to read a storybook to their child/ren and participate in semi-structured qualitative interviews. Transcripts were analyzed thematically using a general inductive approach. The bibliotherapeutic resource reportedly supported parents with communication about these issues without raising emotional distress in either themselves or their children. The key stages of a bibliotherapeutic interaction were facilitated by the use of this resource, and all parents reported that it would have been useful when their children were first tested and/or diagnosed. This study lays the foundation for the application of bibliotherapy as a psycho-educational intervention in genetic counseling and demonstrates that bibliotherapy may improve the process of communication between parents and children regarding pediatric-inherited cancer syndromes.
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Affiliation(s)
- Georgina M Schlub
- Faculty of Health and Medicine, Northern Clinical School, University of Sydney, Camperdown, NSW, Australia.,NSLHD Familial Cancer Service, Department of Cancer Services, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Ashley Crook
- NSLHD Familial Cancer Service, Department of Cancer Services, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Kristine Barlow-Stewart
- Faculty of Health and Medicine, Northern Clinical School, University of Sydney, Camperdown, NSW, Australia
| | - Jane Fleming
- Faculty of Health and Medicine, Northern Clinical School, University of Sydney, Camperdown, NSW, Australia
| | - Judy Kirk
- Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Kathy Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Sian Greening
- Hereditary Cancer Clinic, Illawarra Cancer Care Centre, Wollongong, NSW, Australia
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23
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Smith MB, Albanese-O'Neill A, Yao Y, Wilkie DJ, Haller MJ, Keenan GM. Feasibility of the Web-Based Intervention Designed to Educate and Improve Adherence Through Learning to Use Continuous Glucose Monitor (IDEAL CGM) Training and Follow-Up Support Intervention: Randomized Controlled Pilot Study. JMIR Diabetes 2021; 6:e15410. [PMID: 33560234 PMCID: PMC7902192 DOI: 10.2196/15410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 07/11/2020] [Accepted: 07/23/2020] [Indexed: 01/29/2023] Open
Abstract
Background Proper training and follow-up for patients new to continuous glucose monitor (CGM) use are required to maintain adherence and achieve diabetes-related outcomes. However, CGM training is hampered by the lack of evidence-based standards and poor reimbursement. We hypothesized that web-based CGM training and education would be effective and could be provided with minimal burden to the health care team. Objective The aim of this study was to perform a pilot feasibility study testing a theory-driven, web-based intervention designed to provide extended training and follow-up support to adolescents and young adults newly implementing CGM and to describe CGM adherence, glycemic control, and CGM-specific psychosocial measures before and after the intervention. Methods The “Intervention Designed to Educate and improve Adherence through Learning to use CGM (IDEAL CGM)” web-based training intervention was based on supporting literature and theoretical concepts adapted from the health belief model and social cognitive theory. Patients new to CGM, who were aged 15-24 years with type 1 diabetes for more than 6 months were recruited from within a public university’s endocrinology clinic. Participants were randomized to enhanced standard care or enhanced standard care plus the IDEAL CGM intervention using a 1:3 randomization scheme. Hemoglobin A1c levels and psychosocial measures were assessed at baseline and 3 months after start of the intervention. Results Ten eligible subjects were approached for recruitment and 8 were randomized. Within the IDEAL CGM group, 4 of the 6 participants received exposure to the web-based training. Half of the participants completed at least 5 of the 7 modules; however, dosage of the intervention and level of engagement varied widely among the participants. This study provided proof of concept for use of a web-based intervention to deliver follow-up CGM training and support. However, revisions to the intervention are needed in order to improve engagement and determine feasibility. Conclusions This pilot study underscores the importance of continued research efforts to optimize the use of web-based intervention tools for their potential to improve adherence and glycemic control and the psychosocial impact of the use of diabetes technologies without adding significant burden to the health care team. Enhancements should be made to the intervention to increase engagement, maximize responsiveness, and ensure attainment of the skills necessary to achieve consistent use and improvements in glycemic control prior to the design of a larger well-powered clinical trial to establish feasibility. Trial Registration ClinicalTrials.gov NCT03367351, https://clinicaltrials.gov/ct2/show/NCT03367351.
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Affiliation(s)
- Madison B Smith
- College of Nursing, University of Florida, Gainesville, FL, United States
| | | | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - Michael J Haller
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Gail M Keenan
- Department of Family, Community and Health Systems Science, College of Nursing, University of Florida, Gainesville, FL, United States
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24
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Pais V, Patel BP, Ghayoori S, Hamilton JK. "Counting Carbs to Be in Charge": A Comparison of an Internet-Based Education Module With In-Class Education in Adolescents With Type 1 Diabetes. Clin Diabetes 2021; 39:80-87. [PMID: 33551557 PMCID: PMC7839608 DOI: 10.2337/cd20-0060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Carbohydrate counting is an essential component of type 1 diabetes education but can be difficult for adolescents to learn. Because adolescents are avid users of technology, an Internet-based education module was compared with an in-class education session in terms of carbohydrate counting accuracy in adolescents with type 1 diabetes. Adolescent participants displayed increased carbohydrate counting accuracy after attending an in-class education session compared with an Internet-based education module. These results suggest that online education is best reserved as an adjunctive therapy to in-class teaching in this population.
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Affiliation(s)
- Vanita Pais
- Division of Endocrinology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Barkha P. Patel
- Division of Endocrinology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sholeh Ghayoori
- Division of Endocrinology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jill K. Hamilton
- Division of Endocrinology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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25
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Lau N, Waldbaum S, Parigoris R, O'Daffer A, Walsh C, Colt SF, Yi-Frazier JP, Palermo TM, McCauley E, Rosenberg AR. eHealth and mHealth Psychosocial Interventions for Youths With Chronic Illnesses: Systematic Review. JMIR Pediatr Parent 2020; 3:e22329. [PMID: 33075743 PMCID: PMC7685926 DOI: 10.2196/22329] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND An estimated 12.8% of children and adolescents experience chronic health conditions that lead to poor quality of life, adjustment and coping issues, and concurrent mental health problems. Digital health deployment of psychosocial interventions to support youth with chronic illness has become increasingly popular with the advent of the technological advances in the digital age. OBJECTIVE Our objectives were to systematically review published efficacy studies of eHealth and mHealth (mobile health) psychosocial interventions for youths with chronic illnesses and review intervention theory and treatment components. METHODS PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched for studies published from 2008 to 2019 of eHealth and mHealth psychosocial interventions designed for children and adolescents with chronic illnesses in which efficacy outcomes were reported. We excluded studies of interventions for caregivers, healthy youth, disease and medication management, and telehealth interventions that function solely as a platform to connect patients to providers via phone, text, or videoconference. RESULTS We screened 2551 articles and 133 relevant full-text articles. Sixteen efficacy studies with psychosocial and health outcomes representing 12 unique interventions met the inclusion criteria. Of the included studies, 12 were randomized controlled trials and 4 were prospective cohort studies with no comparison group. Most interventions were based in cognitive behavioral theory and designed as eHealth interventions; only 2 were designed as mHealth interventions. All but 2 interventions provided access to support staff via text, phone, email, or discussion forums. The significant heterogeneity in intervention content, intervention structure, medical diagnoses, and outcomes precluded meta-analysis. For example, measurement time points ranged from immediately postcompletion of the mHealth program to 18 months later, and we identified 39 unique outcomes of interest. The majority of included studies (11/16, 69%) reported significant changes in measured health and/or psychosocial posttreatment outcomes, with small to large effect sizes. CONCLUSIONS Although the available literature on the efficacy of eHealth and mHealth psychosocial interventions for youth with chronic illnesses is limited, preliminary research suggests some evidence of positive treatment responses. Future studies should continue to evaluate whether digital health platforms may be a viable alternative model of delivery to traditional face-to-face approaches.
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Affiliation(s)
- Nancy Lau
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Shayna Waldbaum
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Ryan Parigoris
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Alison O'Daffer
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Casey Walsh
- Department of Health Services, University of Washington, Seattle, WA, United States.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Susannah F Colt
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Elizabeth McCauley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Abby R Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, United States.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
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26
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Boggiss AL, Consedine NS, Schache KR, Jefferies C, Bluth K, Hofman PL, Serlachius AS. A brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating: a feasibility study. Diabet Med 2020; 37:1854-1860. [PMID: 32614482 DOI: 10.1111/dme.14352] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2020] [Indexed: 02/06/2023]
Abstract
AIM To examine the feasibility and acceptability of a brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating behaviour. METHODS Twenty-seven adolescents with type 1 diabetes were recruited and randomized to receive the brief (two 2.5-h sessions) self-compassion intervention, either in the intervention group (n=11) or in a waitlist control group (n=8). The intervention was adapted from the standardized eight-session 'Making Friends with Yourself' programme, and sessions were delivered 1 week apart. Acceptability was assessed through qualitative questionnaires and feasibility was assessed based on session attendance and recruitment metrics. Possible changes to disordered eating behaviour, self-care behaviours, diabetes-related distress, self-compassion, stress and glycaemic control were also assessed. RESULTS Nineteen participants completed the study, and they reported an increased sense of common humanity (acknowledging that we are not alone), mindfulness, and coping resources. In terms of feasibility, recruitment took longer than expected (8 months) and not all participants were able to attend both sessions (nine could only attend one of the two sessions). CONCLUSIONS While self-compassion is a strong conceptual fit for the issues of type 1 diabetes and disordered eating behaviour in adolescence, and the intervention content appears acceptable, feasibility issues were such that brief self-compassion programmes will probably need to be adapted into digital interventions for future research. (Trial registration number: ANZCTR 12619000541101).
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Affiliation(s)
- A L Boggiss
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - N S Consedine
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - K R Schache
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - C Jefferies
- Starship Children's Health, Auckland City Hospital, Auckland, New Zealand
| | - K Bluth
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - P L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - A S Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Psychological interventions for adherence, metabolic control, and coping with stress in adolescents with type 1 diabetes: a systematic review. World J Pediatr 2020; 16:456-470. [PMID: 32185668 DOI: 10.1007/s12519-020-00352-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 02/27/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The aim of this review was to summarize and identify the variations in the effectiveness of psychological interventions on adherence, metabolic control, and coping with stress in adolescents with type 1 diabetes (T1D). METHODS An electronic search of literature was performed using PubMed (NLM), Embase (Ovid), CINAHL Plus (EBSCOhost), PsycINFO (Ovid), and Google Scholar. The search was limited to include articles reported the effect of one of the psychological interventions: cognitive behavioral therapy (CBT), coping skills training (CST), stress management, or psychotherapy intervention. The report included peer-reviewed articles published in English from January 1990 until May 2019 in adolescents with T1D, and summarizes the results of 24 studies that met the inclusion criteria. RESULTS Psychological interventions showed differential effects on adherence, metabolic control, and coping with stress in adolescents with T1D. Behavioral interventions using principles of CBT appear to have a superior positive effect on regimen adherence compared with other types of psychological protocols. In contrast, metabolic control was significantly improved with the implementation of CST and some forms of CBT. Stress management and psychotherapy interventions showed significant promises for adolescents to cope with their diabetes-related daily stressors. CONCLUSIONS However, the findings may add some promises to diabetes management in adolescents, additional research to understand the effect of these interventions is needed.
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28
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Otis M, Zhu J, Mustafa-Kutana SN, Bernier AV, Ma Shum J, Soros Dupre AA, Wang ML. Testing Usability and Feasibility of a Mobile Educator Tool for Pediatric Diabetes Self-Management: Mixed Methods Pilot Study. JMIR Form Res 2020; 4:e16262. [PMID: 32356773 PMCID: PMC7229529 DOI: 10.2196/16262] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/02/2019] [Accepted: 02/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mobile interventions hold promise as an intervention modality to engage children in improving diabetes self-management education, attitudes, and behaviors. OBJECTIVE This pilot study aimed to explore the usability, acceptability, and feasibility of delivering a mobile diabetes educational tool to parent-child pairs in a clinical setting. METHODS This mixed methods pilot study comprised two concurrent phases with differing study participants. Phase 1 used user testing interviews to collect qualitative data on the usability and acceptability of the tool. Phase 2 used a single-arm pre- and poststudy design to quantitatively evaluate the feasibility and preliminary efficacy of the intervention. Study participants (English-speaking families with youth aged 5-14 years with insulin-dependent diabetes) were recruited from an urban hospital in Massachusetts, United States. In phase 1, parent-child pairs were invited to complete the intervention together and participate in 90-min user testing interviews assessing the tool's usability and acceptability. Interview transcripts were analyzed using a directed content analysis approach. In phase 2, parent-child pairs were invited to complete the intervention together in the clinical setting. Measures included parental and child knowledge, attitudes, and behaviors related to diabetes management (self-report surveys) and child hemoglobin A1c levels (medical record extractions); data were collected at baseline and 1-month follow-up. Pre- and postoutcomes were compared using paired t tests and the Fisher exact test. RESULTS A total of 11 parent-child pairs (N=22) participated in phase 1 of the study, and 10 parent-child pairs (N=20) participated in phase 2 of the study. Participants viewed the mobile educational tool as acceptable (high engagement and satisfaction with the layout, activities, and videos) and identified the areas of improvement for tool usability (duration, directions, and animation). CONCLUSIONS The findings from this pilot study suggest that the mobile educational tool is an informative, engaging, and feasible way to deliver diabetes self-management education to parents and children in an urban hospital setting. Data will inform future iterations of this mobile diabetes educational intervention to improve usability and test intervention efficacy.
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Affiliation(s)
- Marisa Otis
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Jack Zhu
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Suleiman N Mustafa-Kutana
- Division of Pediatric Endocrinology and Metabolism, Boston Medical Center, Boston, MA, United States
| | - Angelina V Bernier
- Division of Pediatric Endocrinology, University of Florida, Gainesville, FL, United States
| | - Julio Ma Shum
- Division of Pediatric Endocrinology and Metabolism, Boston Medical Center, Boston, MA, United States
| | - Arlette A Soros Dupre
- Division of Pediatric Endocrinology and Metabolism, Boston Medical Center, Boston, MA, United States
| | - Monica L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
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29
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Joiner KL, DeJonckheere M, Whittemore R, Grey M. Perceptions and experiences of living with type 1 diabetes among Latino adolescents and parents with limited English proficiency. Res Nurs Health 2020; 43:263-273. [PMID: 32281136 DOI: 10.1002/nur.22019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/12/2020] [Accepted: 03/28/2020] [Indexed: 11/07/2022]
Abstract
We explored perceptions and experiences of living with type 1 diabetes mellitus (T1DM) among U.S. Latino adolescents (age 12-19 years) with T1DM and parents with limited English proficiency. We used a qualitative descriptive approach with semi-structured interviews of adolescents together with their parents. Interview data were reviewed, coded, and combined into themes about participant experiences with T1DM. Twenty-four adolescents (mean age: 15.4 years) and 23 parents participated. Analysis resulted in three themes: (a) Understanding and adapting to T1DM (i.e., initial fear and misunderstandings of T1DM; adolescents' reflections on living with a chronic health condition); (b) Coming to terms with social and environmental influences on T1DM self-management (i.e., T1DM as disruptive to school and social activities; dealing with stigma and judgments related to diabetes); and, (c) Integrating T1DM self-management expectations with components of Latino cultures (i.e., orientation toward family well-being; parent concerns about cultural preferences that influence food choices, positive influence of spirituality and religiousness; parental views of their current health care in comparison to that available in their place of birth). Adolescents and their parents reported experiences that are universal to adolescents with T1DM in addition to challenges that are unique to Latinos. Efforts aimed at improving T1DM self-management during adolescence with this population need to be tailored to meet the unique social and cultural contexts and delivered in a culturally and linguistically congruent manner.
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Affiliation(s)
- Kevin L Joiner
- School of Nursing, University of Michigan, Ann Arbor, Michigan
| | | | | | - Margaret Grey
- School of Nursing, Yale University, Orange, Connecticut
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30
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Tornivuori A, Tuominen O, Salanterä S, Kosola S. A systematic review on randomized controlled trials: Coaching elements of digital services to support chronically ill adolescents during transition of care. J Adv Nurs 2020; 76:1293-1306. [PMID: 32030792 DOI: 10.1111/jan.14323] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 12/20/2019] [Accepted: 01/30/2020] [Indexed: 12/14/2022]
Abstract
AIMS To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. DESIGN Systematic review without meta-analysis. DATA SOURCES MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. REVIEW METHODS Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. CONCLUSION E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. IMPACT Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.
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Affiliation(s)
- Anna Tornivuori
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Outi Tuominen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Sanna Salanterä
- Department of Nursing science, University of Turku, Turku University Hospital , Turku, Finland
| | - Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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31
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Mayen S, De Clifford-Faugère G, Colson S. Letter to the Editor Regarding "Clinical Trial Recruitment and Retention of College Students with Type 1 Diabetes via Social Media: An Implementation Case Study": A Commentary on Wisk et al (2019). J Diabetes Sci Technol 2020; 14:185-186. [PMID: 31596131 PMCID: PMC7189149 DOI: 10.1177/1932296819879909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sandrine Mayen
- Faculté des sciences médicales et
paramédicales, Aix Marseille Université, EA3279-CEReSS, France
- Sandrine Mayen, Faculté des sciences
médicales et paramédicales, Aix Marseille Université, EA3279-CEReSS, Ecole des
Sciences Infirmières, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5,
Marseille, France.
| | | | - Sébastien Colson
- Faculté des sciences médicales et
paramédicales, Aix Marseille Université, EA3279-CEReSS, France
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32
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Liu F, Guan Y, Li X, Xie Y, He J, Zhou ZG, Li L. Different Effects of Structured Education on Glycemic Control and Psychological Outcomes in Adolescent and Adult Patients with Type 1 Diabetes: A Systematic Review and Meta-Analysis. Int J Endocrinol 2020; 2020:9796019. [PMID: 32184823 PMCID: PMC7061135 DOI: 10.1155/2020/9796019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 11/30/2019] [Indexed: 12/16/2022] Open
Abstract
AIM This systematic review aimed at investigating the effectiveness of structured education (SE) in improving glycemic control and psychological outcomes in adolescent and adult patients with type 1 diabetes. METHODS Electronic databases (EMBASE, Medline, PubMed, and the Cochrane Library) and the reference lists of included studies were searched from the beginning of the database through April 2019. Randomized controlled trials comparing SE with a control condition and reporting a change in glycosylated hemoglobin (HbA1c) level were included. The primary outcome was glycemic control measured by HbA1c. Secondary outcomes were diabetes-related distress, well-being, depression, and quality of life. RESULTS Eighteen studies representing 2759 patients were included. Twelve studies targeted adolescents and six targeted adults. Adolescent patients who were randomized to the intervention group did not show significant improvement of HbA1c in the short (SMD = -0.04; 95% CI: -0.14 to 0.06; P=0.41), medium (SMD = -0.03; 95% CI: -0.13 to 0.07; P=0.41), medium (SMD = -0.03; 95% CI: -0.13 to 0.07; P=0.41), medium (SMD = -0.03; 95% CI: -0.13 to 0.07; P=0.41), medium (SMD = -0.03; 95% CI: -0.13 to 0.07; P=0.41), medium (SMD = -0.03; 95% CI: -0.13 to 0.07. CONCLUSIONS Development of more efficient SE programs according to the patients' personal characteristics is needed.
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Affiliation(s)
- Fang Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
- Department of Metabolism and Endorinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yuzhu Guan
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Xia Li
- Department of Metabolism and Endorinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yuting Xie
- Department of Metabolism and Endorinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jing He
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhi-Guang Zhou
- Department of Metabolism and Endorinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- National Clinical Research Center for Metabolic Disease, Changsha, China
| | - Lezhi Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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Stanger C, Lansing AH, Scherer E, Budney A, Christiano AS, Casella SJ. A Web-Delivered Multicomponent Intervention for Adolescents with Poorly Controlled Type 1 Diabetes: A Pilot Randomized Controlled Trial. Ann Behav Med 2019; 52:1010-1022. [PMID: 30418521 DOI: 10.1093/abm/kay005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Type 1 diabetes is associated with significant mortality and economic cost. Management of type 1 diabetes involves completing multiple daily adherence behaviors, and many adolescents struggle with self-management and show poor glycemic control. Purpose The purpose was to conduct an unblinded pilot randomized controlled parallel-group study of a web-delivered multicomponent intervention targeting self-monitoring of blood glucose, working memory, and parent supervision of diabetes care among adolescents with type 1 diabetes. Intervention components included high magnitude incentives for adolescents and parents, motivational and cognitive behavioral therapy and working memory training for adolescents, and training in contingency contracting for parents. Methods Adolescents (N = 114) with poorly controlled type 1 diabetes were screened, and N = 61 were randomized using minimum likelihood allocation to usual care (usual care, N = 31) or to a 25-week/15-session web-delivered intervention (WebRx, N = 30). Results At the end of treatment, adolescents in WebRx had higher self-monitoring of blood glucose (d = 0.58) (primary outcome), better visual spatial working memory (d = 0.48) and inhibition (d = 0.98), and lower HbA1c (d = 0.45) than those in usual care. WebRx parents reported more frequent review of the adolescent's glucometer (d = 1.30) and reduced family conflict (d = 0.56). Between-condition differences were maintained 6 months later in self-monitoring of blood glucose (d = 0.42), visual spatial working memory (d = 0.76), family conflict (d = 0.50), and HbA1c (d = 0.44). Conclusions Results showing sustained effects on self-monitoring of blood glucose and HbA1c support moving forward with a larger trial to test this innovative web-delivered and multicomponent intervention. ClinicalTrials.gov Number (NCT01722643).
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Affiliation(s)
- Catherine Stanger
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Amy Hughes Lansing
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Emily Scherer
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Alan Budney
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Ann S Christiano
- Department of Pediatric Endocrinology, Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Samuel J Casella
- Department of Pediatric Endocrinology, Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Van Allen J, Noser AE, Littlefield AK, Seegan PL, Clements M, Patton SR. Measuring Self-Efficacy in the Context of Pediatric Diabetes Management: Psychometric Properties of the Self-Efficacy for Diabetes Scale. J Pediatr Psychol 2019; 43:143-151. [PMID: 29106615 DOI: 10.1093/jpepsy/jsx094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/02/2017] [Indexed: 11/12/2022] Open
Abstract
Objective The Self-Efficacy for Diabetes Scale (SED) is a widely used measure of diabetes-specific self-efficacy with three subscales: diabetes-specific self-efficacy (SED-D), medical self-efficacy (SED-M), and general self-efficacy (SED-G). The present study examined the factor structure and construct validity of the SED in 116 youth, aged 10-16 years (13.60 ± 1.87), with type 1 diabetes mellitus. Methods Confirmatory factor analysis (CFA) was used to examine the factor structure of the SED. Correlational and regression analyses examined relations between subscales and select outcomes. Results CFA of the original three-factor structure provided a poor fit to the data. Factor models using rescaled items were tested. Results provided preliminary evidence for the SED-D as an independent one-factor model, and for a reduced one-factor model. Significant associations were found between the SED subscales, responsibility for diabetes management, and glycated hemoglobin. Conclusions Results provide limited support for the SED-D as a reliable and valid measure of diabetes-specific self-efficacy.
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Affiliation(s)
- Jason Van Allen
- Clinical Psychology Program, Department of Psychological Sciences, Texas Tech University
| | - Amy E Noser
- Clinical Child Psychology Program, University of Kansas
| | - Andrew K Littlefield
- Clinical Psychology Program, Department of Psychological Sciences, Texas Tech University
| | - Paige L Seegan
- Clinical Psychology Program, Department of Psychological Sciences, Texas Tech University
| | - Mark Clements
- Division of Endocrinology & Diabetes, Department of Pediatrics, Children's Mercy Hospital
| | - Susana R Patton
- Department of Pediatrics, University of Kansas Medical Center
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35
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Albanese-O'Neill A, Schatz DA, Thomas N, Bernhardt JM, Cook CL, Haller MJ, Bernier AV, Silverstein JH, Westen SC, Elder JH. Designing Online and Mobile Diabetes Education for Fathers of Children With Type 1 Diabetes: Mixed Methods Study. JMIR Diabetes 2019; 4:e13724. [PMID: 31389338 PMCID: PMC6701161 DOI: 10.2196/13724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/23/2019] [Accepted: 06/06/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Fathers make unique and central contributions to the health of their children. However, research in type 1 diabetes (T1D) education largely ignores the needs of fathers, including during the development of online and mobile educational materials. OBJECTIVE The purpose of this study was to solicit and incorporate input from fathers of children with T1D into the design, content, and infrastructure of a suite of online diabetes self-management education and support (DSMES) resources. METHODS The study took part in three phases: (1) exploratory research, (2) website and subdomain development, and (3) evaluation. Fathers of children with T1D (n=30) completed surveys and semistructured qualitative interviews. Thematic content analysis was used to identify fathers' content and design preferences. An online DSMES website (T1DToolkit.org) and a separate mobile subdomain targeting fathers (Mobile Diabetes Advice for Dads, or mDAD) were developed. A prototype of the site for fathers was evaluated by 33 additional father participants. End user feedback was elicited via survey. RESULTS Participants in the exploratory phase were enthusiastic about the online diabetes resources. Preferences included high-quality design, availability via mobile phone and tablet, brief text content supplemented with multimedia and interactive features, reminders via text or email, endorsement by medical professionals, and links to scientific evidence. The mDAD subdomain received high usability and acceptability ratings, with 100% of participants very likely or likely to use the site again. CONCLUSIONS The development of eHealth educational platforms for fathers of children with T1D remains an unmet need in optimizing diabetes management. This study incorporated fathers' feedback into the development of a suite of online diabetes education resources. The findings will serve as the basis for future research to assess the clinical efficacy of the website, its subdomain targeting fathers, and additional subdomains targeting unique populations.
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Affiliation(s)
| | - Desmond A Schatz
- College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole Thomas
- College of Medicine, University of Florida, Gainesville, FL, United States
| | - Jay M Bernhardt
- Moody College of Communications, University of Texas at Austin, Austin, TX, United States
| | - Christa L Cook
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Michael J Haller
- College of Medicine, University of Florida, Gainesville, FL, United States
| | - Angelina V Bernier
- College of Medicine, University of Florida, Gainesville, FL, United States
| | | | - Sarah C Westen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jennifer H Elder
- College of Nursing, University of Florida, Gainesville, FL, United States
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Morone J. Systematic review of sociodemographic representation and cultural responsiveness in psychosocial and behavioral interventions with adolescents with type 1 diabetes. J Diabetes 2019; 11:582-592. [PMID: 30565425 DOI: 10.1111/1753-0407.12889] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/31/2018] [Accepted: 12/09/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The increasing incidence of type 1 diabetes (T1D) in youth aged less than 20 years in the USA is a mounting public health concern. Specific sociodemographic characteristics-racial/ethnic minority, low socioeconomic status (SES), single-parent home and underinsured-have been associated with increased risk for poor glycemic control and poor self-management in adolescents with T1D. METHODS Sample demographic and cultural responsiveness methods in psychosocial and behavioral interventions focused on improving self-management and glycemic control in adolescents with T1D were systematically evaluated, to identify if studies were targeting these high-risk groups. Keyword searches of PsychInfo, PubMed and CINAHL identified 259 studies published between 2006 and 2016, of adolescents (13-18 years old) with T1D; 28 studies met inclusion criteria. RESULTS Samples focused predominantly on White adolescents with fair glycemic control, from middle-high income, two-parent households with private insurance. The majority of studies scored poorly in cultural responsiveness and moderately in culturally responsive reporting. Studies lacked descriptions of culturally inclusive recruitment and sampling methods, and use of culturally responsive assessments for diverse groups. The majority of studies recruited and enrolled homogeneous adolescent samples from the lowest risk groups. CONCLUSION T1D intervention researchers must increase targeted recruitment and sampling methods to include more high-risk pediatric T1D groups, expand sociodemographic reporting, and increase the use of culturally responsive recruitment and sampling methods, such as those used in community-based participatory research. Such efforts have the potential to reduce T1D disparities by making interventions more relevant to the unique needs, goals and priorities of highest risk groups.
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Affiliation(s)
- Jennifer Morone
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Miele F, Clementi S, Gennaro R, Nicolao I, Romanelli T, Speese K, Piras EM. Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals. JMIR Diabetes 2019; 4:e11343. [PMID: 31094332 PMCID: PMC6533872 DOI: 10.2196/11343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/16/2018] [Accepted: 03/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The diffusion of information and communication technologies (ICTs) in type 1 diabetes (T1D) management has generated a debate on the ways in which ICTs can support the patient-provider relationship. Several studies have focused on text messages. Most of the literature proposes quantitative analysis of the impact of text messaging on the clinical conditions of patients and/or their satisfaction with the technology, while the qualitative studies have focused mainly on patients' perceptions about strengths and weaknesses of this technology. OBJECTIVE In contrast to past studies, we adopted a qualitative approach for the in-depth examination of patient-health care professionals' interactions in text messaging. METHODS The study focused on the use of the Trento Cartella Clinica del Cittadino Diabetes System (TreC-DS), a digital platform with a built-in messaging system, in two diabetes centers, integrating message analysis with interviews with patients and health care professionals. Each center focused on a specific patient profile: the first one focused on pregnant women with T1D and the second one focused on adult patients with poorly controlled diabetes. RESULTS The main results of the study were as follows: (1) Health care professionals and patients perceived the messaging system as useful for sharing information (ie, pregnant women for prescriptions and adults with poorly controlled diabetes for advice); (2) The content and communication styles of the two centers differed: in the case of pregnant women, interactions via text messaging were markedly prescriptive, while in the case of adult patients with poorly controlled diabetes, they were conceived as open dialogues; and (3) Conversations were initiated mainly by professionals; in the cases considered, it was mainly the diabetes center that decided whether a messaging conversation was needed. CONCLUSIONS The results show how the features of interactions of text messaging changed based on the patient profiles in two different centers. In addition, in both diabetes centers that were involved, the system seems to have laid a foundation for a closer relationship between patients and health care professionals.
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Affiliation(s)
- Francesco Miele
- e-Health Research Unit, Bruno Kessler Foundation, Trento, Italy
| | - Silvia Clementi
- Azienda Provinciale per i Servizi Sanitari, Diabetes Center, Trento, Italy
| | - Renzo Gennaro
- Azienda Provinciale per i Servizi Sanitari, Diabetes Center, Rovereto, Italy
| | - Ilaria Nicolao
- Azienda Provinciale per i Servizi Sanitari, Diabetes Center, Trento, Italy
| | - Tiziana Romanelli
- Azienda Provinciale per i Servizi Sanitari, Diabetes Center, Trento, Italy
| | - Katja Speese
- Azienda Provinciale per i Servizi Sanitari, Diabetes Center, Rovereto, Italy
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Abstract
AIMS The aim of the study was to evaluate Facebook group as possible communication tool to improve glucose control in adolescents and young people with type 1 diabetes (T1D). METHODS This retrospective and cross-sectional study included 728 T1D patients (age 11-25) on continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) treated at the center for insulin pump and glucose sensor in Skopje from January 2012 to December 2017. Data were collected through the electronic medical record system and cross-sectional analysis (telephone, social media (Facebook and Viber) or email). Patients were analyzed in two groups: (a) non-Internet group, with 398 patients treated using standard medical protocol with regular clinic visits; (b) Internet group, with 330 patients who, besides standard medical protocol, were active members of a national closed Facebook group on diabetes. Both the non-Internet and Internet groups had regular visits every 2-3 months. Patients from the Internet group were members of the closed Facebook group "Diabetes Macedonia" and had an opportunity to interact with questions, answers, and comments on diabetes care. An additional analysis was performed of the Internet group on combined use of Facebook and Viber. Average HbA1c levels were compared in both groups. RESULTS Each patient from the Facebook group had 1.5 ± 3.5 posts per day. Hba1c was significantly lower in patients from the Internet group (7.1 ± 3.2%; 54 ± 35 mmol/mol) compared to patients from the non-Internet group (7.6 ± 2.8%; 60 ± 31 mmol/mol). CONCLUSIONS Social media like Facebook and Viber can be additional communication tool in adolescents and young people with T1D and can significantly lower HbA1c compared to patients without social media use. CSII patients are more likely to use both social media (Facebook and Viber) compared with MDI patients (Facebook only).
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Affiliation(s)
- Goran Petrovski
- University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Skopje, Macedonia
- Goran Petrovski, MD, PhD, University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Vodnjanska 17, 1000 Skopje, Macedonia.
| | - Marija Zivkovic
- University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Skopje, Macedonia
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Tutus D, Plener PL, Niemitz M. [Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2018; 48:57-75. [PMID: 30526289 DOI: 10.1024/1422-4917/a000640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review Abstract. Introduction: This study provides an overview of existing internet-based evidence-based cognitive behavioral interventions (iCBT) for children/adolescents and their parents. The studies were evaluated based on preliminary defined quality criteria regarding their usability in the healthcare system. Methods: The review was performed according to PRISMA guidelines and evaluated the scientific literature concerning to iCBT. We conducted a comprehensive literature search of PubMed, PsychINFO, PsychARTICLES, PsychNDEX and Science Direct using relevant keywords. Studies were rated according to 10 previously predefined quality measures. Results: A total of 4,479 articles were screened, 62 of which were selected for further analysis. Thereof, 24 international iCBT programs with 50 randomized controlled trials (RCTs) were evaluated and met the quality criteria (M = 7.25, SD = 1.07). Further 13 publications showed preliminary efficacy for another 11 international iCBT programs and met the quality criteria (M = 7.45, SD = .82). There was no significant difference between programs evaluated within and without RCTs t(33) = -.56, p = .58. Conclusions: Our results indicate that multiple international iCBT programs exist. Because in Germany the waiting time for psychotherapeutic or psychiatric treatment is still about five months, iCBT programs have the potential to reduce this gap.
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Affiliation(s)
- Dunja Tutus
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland
| | - Paul L Plener
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland.,Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Österreich
| | - Mandy Niemitz
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland
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Grady PA, Gough LL. El automanejo de las enfermedades crónicas: un método integral de atención. Am J Public Health 2018. [DOI: 10.2105/ajph.2014.302041s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Patricia A. Grady
- Instituto Nacional de Investigación en Enfermería, Institutos Nacionales de Salud, Bethesda, Maryland, Estados Unidos de América
| | - Lisa Lucio Gough
- Instituto Nacional de Investigación en Enfermería, Institutos Nacionales de Salud, Bethesda, Maryland, Estados Unidos de América
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Self-Management: A Comprehensive Approach to Management of Chronic Conditions. Am J Public Health 2018; 108:S430-S436. [PMCID: PMC6291774 DOI: 10.2105/ajph.2014.302041r] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2014] [Indexed: 08/05/2023]
Abstract
For both clinical and economic reasons, the increasing number of persons living with chronic conditions represents a public health issue of growing importance. Emphasizing patient responsibility, and acting in concert with the provider community, self-management represents a promising strategy for treating chronic conditions—moving beyond education to teaching individuals to actively identify challenges and solve problems associated with their illness. Self-management also shows potential as an effective paradigm across the prevention spectrum (primary, secondary, and tertiary) by establishing a pattern for health early in life and providing strategies for mitigating illness and managing it in later life. We suggest ways to advance research methods and practical applications of self-management as steps in its future development and implementation.
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Delamater AM, de Wit M, McDarby V, Malik JA, Hilliard ME, Northam E, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19 Suppl 27:237-249. [PMID: 30058247 DOI: 10.1111/pedi.12736] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023] Open
MESH Headings
- Adaptation, Psychological/physiology
- Adolescent
- Burnout, Psychological/psychology
- Burnout, Psychological/therapy
- Child
- Consensus
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Endocrinology/organization & administration
- Endocrinology/standards
- Humans
- International Cooperation
- Neurodevelopmental Disorders/therapy
- Pediatrics/organization & administration
- Pediatrics/standards
- Practice Patterns, Physicians'/standards
- Psychotherapy/methods
- Psychotherapy/standards
- Quality of Life/psychology
- Resilience, Psychological
- Societies, Medical/organization & administration
- Societies, Medical/standards
- Stress, Psychological/etiology
- Stress, Psychological/therapy
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Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Maartje de Wit
- Department of Medical Psychology, EMGO Institute for Health & Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Vincent McDarby
- National Children's Research Centre and Our Lady's Children's Hospital, Dublin, Ireland
| | - Jamil A Malik
- Center of Excellence, National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Phelan H, Lange K, Cengiz E, Gallego P, Majaliwa E, Pelicand J, Smart C, Hofer SE. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents. Pediatr Diabetes 2018; 19 Suppl 27:75-83. [PMID: 30175451 DOI: 10.1111/pedi.12762] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Helen Phelan
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, Australia
| | - Karin Lange
- Department Medical Psychology OE 5430, Hannover Medical School, Hannover, Germany
| | - Eda Cengiz
- Division of Pediatric Endocrinology, Yale School of Medicine, New Haven, Connecticut, USA.,School of Medicine, Koc University, Istanbul, Turkey
| | - Patricia Gallego
- Department of Pediatrics, Children's Hospital London, Health Sciences Centre, London, Ontario, Canada.,Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Edna Majaliwa
- Department of Paediatric and Child Health, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Julie Pelicand
- Medical School, University of Valparaiso, San Felipe, Chile
| | - Carmel Smart
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, Australia
| | - Sabine E Hofer
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
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Abstract
Social media and new media are becoming increasingly important in the lives of preteens and teens. This article reviews what is currently known about positive and negative effects of social media, social networking, and internet use and what safety measures should be considered.
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Affiliation(s)
- Marjorie Hogan
- 1 University of Minnesota School of Medicine, Minneapolis, MN, USA
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45
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Bergner EM, Whittemore R, Patel NJ, Savin KL, Hamburger ER, Jaser SS. Participants' Experience and Engagement in Check It!: a Positive Psychology Intervention for Adolescents with Type 1 Diabetes. TRANSLATIONAL ISSUES IN PSYCHOLOGICAL SCIENCE 2018; 4:215-227. [PMID: 30505889 DOI: 10.1037/tps0000161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Problems with adherence are common among adolescents with type 1 diabetes (T1D), who must follow a complex treatment regimen. Positive psychology interventions increase adherence and improve health outcomes in adults with chronic conditions; however, they have not been translated to pediatric populations. We evaluated the acceptability and feasibility of Check It!, a positive psychology intervention to improve adherence in adolescents with T1D. Adolescents with T1D and their parents were randomized to a positive psychology intervention (via phone or text message) or an attention control (education) group. Exit interviews and satisfaction surveys were conducted with adolescents (n=63) and parents (n=55) to assess the acceptability and feasibility of Check it! from a representative sample of each group. Chi-square, t-tests, ANOVA and content analysis methods were used to analyze data. Parents and adolescents indicated interest in the intervention, and enrollment numbers support feasibility. In terms of intervention delivery, we identified challenges in implementing the positive psychology reminders to adolescents, particularly in the phone group. Parents in the positive psychology group appreciated the reminders to provide affirmations to their children, and adolescents enjoyed the affirmations and reported using the positive psychology exercises. Regarding acceptability, participants in both groups reported high satisfaction with the intervention overall. Participants reported favorable experiences with Check It!, and findings indicate that text messages are more feasible than phone calls for interventions with adolescents. Overall, a positive psychology intervention delivered with automated text messages is feasible and acceptable to adolescents with T1D and their parents.
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Canter KS, Christofferson J, Scialla MA, Kazak AE. Technology-Focused Family Interventions in Pediatric Chronic Illness: A Systematic Review. J Clin Psychol Med Settings 2018; 26:68-87. [DOI: 10.1007/s10880-018-9565-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Duke DC, Barry S, Wagner DV, Speight J, Choudhary P, Harris MA. Distal technologies and type 1 diabetes management. Lancet Diabetes Endocrinol 2018; 6:143-156. [PMID: 28867311 DOI: 10.1016/s2213-8587(17)30260-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 06/21/2017] [Accepted: 07/03/2017] [Indexed: 02/09/2023]
Abstract
Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals. In this Review, we summarise the empirical literature to provide current information about the effectiveness of available distal technologies to improve type 1 diabetes management. We also discuss privacy, ethics, and regulatory considerations, issues of global adoption, knowledge gaps in distal technology, and recommendations for future directions.
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Affiliation(s)
- Danny C Duke
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA.
| | - Samantha Barry
- Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA
| | - David V Wagner
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Deakin University, and Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Michael A Harris
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA
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Jaser SS, Patel N, Xu M, Tamborlane WV, Grey M. Stress and Coping Predicts Adjustment and Glycemic Control in Adolescents with Type 1 Diabetes. Ann Behav Med 2018; 51:30-38. [PMID: 27496164 DOI: 10.1007/s12160-016-9825-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescents with type 1 diabetes are at increased risk for deteriorating glycemic control, poor quality of life, and depressive symptoms. Stress and coping are related to these outcomes in adolescents with diabetes, yet few studies have examined these constructs longitudinally. PURPOSE This study aimed to describe stress and coping in adolescents with type 1 diabetes and to examine coping strategies as predictors of adolescent adjustment (i.e., depressive symptoms, quality of life) and glycemic control. METHODS Adolescents with type 1 diabetes completed measures of diabetes-related stress, coping, symptoms of depression, and quality of life at baseline, 6 months, and 12 months. Data on glycemic control were collected from the adolescents' medical charts. RESULTS The adolescents' use of primary control coping (e.g., problem solving) and secondary control engagement coping (e.g., positive thinking) strategies predicted significantly fewer problems with quality of life and fewer depressive symptoms over time. In contrast, the use of disengagement coping strategies (e.g., avoidance) predicted more problems with quality of life and depressive symptoms. Coping was not a significant predictor of glycemic control. Coping mediated the effects of diabetes-related stress on depressive symptoms and quality of life. CONCLUSIONS The ways in which adolescents with type 1 diabetes cope with diabetes-related stress predict quality of life and symptoms of depression but not glycemic control. Through the use of screening to identify adolescent's diabetes-related stress and targeted interventions to improve coping strategies, there is potential to improve outcomes.
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Affiliation(s)
- Sarah S Jaser
- Vanderbilt University, DOT 11136, 2200 Children's Way, Nashville, TN, 37232, USA.
| | - Niral Patel
- Vanderbilt University, DOT 11136, 2200 Children's Way, Nashville, TN, 37232, USA
| | - Meng Xu
- Vanderbilt University, DOT 11136, 2200 Children's Way, Nashville, TN, 37232, USA
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49
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Psychoeducational interventions to improve adolescents’ medical management of diabetes: A comprehensive review. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.70357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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50
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Boogerd E, Maas-Van Schaaijk NM, Sas TC, Clement-de Boers A, Smallenbroek M, Nuboer R, Noordam C, Verhaak CM. Sugarsquare, a Web-Based Patient Portal for Parents of a Child With Type 1 Diabetes: Multicenter Randomized Controlled Feasibility Trial. J Med Internet Res 2017; 19:e287. [PMID: 28830853 PMCID: PMC5585595 DOI: 10.2196/jmir.6639] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 11/25/2016] [Accepted: 12/18/2016] [Indexed: 12/31/2022] Open
Abstract
Background Raising a child with type 1 diabetes (T1D) means combining the demands of the disease management with everyday parenting, which is associated with increased levels of distress. A Web-based patient portal, Sugarsquare, was developed to support parents, by providing online parent-professional communication, online peer support and online disease information. Objective The first aim of this study was to assess the feasibility of conducting a multicenter, randomized controlled trial in Dutch parents of a child with T1D. The second aim was to assess the feasibility of implementing Sugarsquare in clinical practice. Methods The parents of 105 children (N=105) with T1D below the age of 13 participated in a 6-month multicenter randomized controlled feasibility trial. They were randomly assigned to an experimental (n=54, usual care and Sugarsquare) or a control group (n=51, usual care). Attrition rates and user statistics were gathered to evaluate feasibility of the trial and implementation. To determine potential efficacy, the parenting stress index (PSI-SF) was assessed at baseline (T0) and after 6 months (T1). Results Of a potential population of parents of 445 children, 189 were willing to participate (enrollment refusal=57.5%, n=256), 142 filled in the baseline questionnaire (baseline attrition rate=25%, n=47), and 105 also filled in the questionnaire at T1 (post randomization attrition rate during follow-up=26%, n=32). As such, 24% of the potential population participated. Analysis in the experimental group (n=54) revealed a total of 32 (59%) unique users, divided into 12 (38%) frequent users, 9 (28%) incidental users, and 11 (34%) low-frequent users. Of the total of 44 professionals, 34 (77%) logged in, and 32 (73%) logged in repeatedly. Analysis of the user statistics in the experimental group further showed high practicability and integration in all users, moderate acceptability and demand in parents, and high acceptability and demand in health care professionals. Baseline parenting stress index scores were related to the parents’ frequency of logging on (ρ=.282, P=.03) and page-views (ρ=.304, P=.01). No significant differences in change in parenting stress between experimental and control group were found (F3,101=.49, P=.49). Conclusions The trial can be considered feasible, considering the average enrollment refusal rate, baseline attrition rate and postrandomization attrition rate, compared to other eHealth studies, although lower than hypothesized. Implementing Sugarsquare in clinical practice was partly feasible, given moderate demand and acceptability in parent users and lack of potential efficacy. Parents who reported higher levels of parenting stress used Sugarsquare more often than other parents, although Sugarsquare did not reduce parenting stress. These results indicate that Web-based interventions are a suitable way of providing parents of children with T1D with additional support. Future studies should determine how Sugarsquare could reduce parenting stress, for instance by adding targeted interventions. Factors potentially contributing to successful implementation are suggested. Trial Registration Nederlands Trial Register Number: NTR3643; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3643 (Archived by WebCite at http://www.webcitation.org/6qihOVCi6)
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Affiliation(s)
- Emiel Boogerd
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nienke M Maas-Van Schaaijk
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands.,Children's Diabetes Center Nijmegen, Nijmegen, Netherlands
| | - Theo C Sas
- Department of Pediatrics, Albert Schweitzer Hospital, Dordrecht, Netherlands
| | | | - Mischa Smallenbroek
- Department of Pediatrics, Medical Center Leeuwarden, Leeuwarden, Netherlands
| | - Roos Nuboer
- Department of Pediatrics, Meander Medical Center, Amersfoort, Netherlands
| | - Cees Noordam
- Children's Diabetes Center Nijmegen, Nijmegen, Netherlands.,Department of Pediatrics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chris M Verhaak
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
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