Health Mindset and Health Outcomes for Adolescents with Type 1 Diabetes

Abstract

Background: Health mindset theory is a novel approach to the study of health outcomes in pediatric populations. Health mindsets have been found to influence how individuals perceive illness and have been linked to health outcomes in adolescents with T1D. Specifically, individuals with a “fixed” mindset of health view illness more negatively and have worse outcomes than those with a “growth” mindset who believe that health can be improved through effort. Methods: A cohort of adolescents with T1D was followed across the transition from pediatric to adult care to assess differences in their health outcomes over time. We predicted that having a growth mindset would be a protective factor for young adults as they take greater control over their health care. Results: Ninety-one participants aged 12-19 with T1D were recruited, with 70 transitioning to adult care during the study period. 61% had a growth mindset while 39% had a fixed mindset of health. Overall, average A1c after transition was lower for participants with a growth vs. a fixed mindset. The most notable difference was found for participants who had the highest A1c before transition (>10%). In this group, growth-mindset adolescents showed a significant improvement in A1c levels compared to those with a fixed mindset (p<.05). Further, a greater percentage of adolescents with a growth (28%) vs. a fixed (9%) mindset was able to reach a target A1c of less than 7%. Age at time of transition (Mean=19 years) was similar for those with fixed and growth mindsets. Conclusion: In this study of adolescents with T1D, having a growth mindset was linked to better glycemic outcomes after transitioning to adult care. Improvement in A1c was greatest for those young adults with a growth mindset who had the poorest glycemic control before transition. This suggests that health mindset might interact with changes in age or maturity level, particularly for young adults, and so may prove to be a powerful target for efforts to improve health maintenance in this population. Disclosure L. Nally: None. C. Mueller: None.