Abstract
BackgroundSupportive parent involvement for adolescents’ type 1 diabetes (T1D) self-management promotes optimal diabetes outcomes. However, family conflict is common and can interfere with collaborative family teamwork. Few interventions have used explicitly strengths-based approaches to help reinforce desired management behaviors and promote positive family interactions around diabetes care.ObjectiveThe aim of this protocol was to describe the development of a new, strengths-based behavioral intervention for parents of adolescents with T1D delivered via a mobile-friendly Web app called Type 1 Doing Well.MethodsTen adolescent-parent dyads and 5 diabetes care providers participated in a series of qualitative interviews to inform the design of the app. The 3- to 4-month pilot intervention will involve 82 parents receiving daily prompts to use the app, in which they will mark the diabetes-related strength behaviors (ie, positive attitudes or behaviors related to living with or managing T1D) their teen engaged in that day. Parents will also receive training on how to observe diabetes strengths and how to offer teen-friendly praise via the app. Each week, the app will generate a summary of the teen’s most frequent strengths from the previous week based on parent reports, and parents will be encouraged to praise their teen either in person or from a library of reinforcing text messages (short message service, SMS).ResultsThe major outcomes of this pilot study will include intervention feasibility and satisfaction data. Clinical and behavioral outcomes will include glycemic control, regimen adherence, family relationships and conflict, diabetes burden, and health-related quality of life.ConclusionsThis strengths-based, mobile health (mHealth) intervention aims to help parents increase their awareness of and efforts to support their adolescents’ engagement in positive diabetes-related behaviors. If efficacious, this intervention has the potential to reduce the risk of family conflict, enhance collaborative family teamwork, and ultimately improve diabetes outcomes.Trial RegistrationClinicalTrials.gov NCT02877680; https://clinicaltrials.gov/ct2/show/NCT02877680 (Archived by WebCite at http://www.webcitation.org/6xTAMN5k2)
Highlights
Background and RationaleType 1 diabetes (T1D) is one of the most common pediatric chronic conditions [1]: between 2001 and 2009, the prevalence among people under 20 years of age in the United States approached 1 in 500 youths
Clinical and behavioral outcomes will include glycemic control, regimen adherence, family relationships and conflict, diabetes burden, and health-related quality of life. This strengths-based, mobile health intervention aims to help parents increase their awareness of and efforts to support their adolescents’ engagement in positive diabetes-related behaviors. This intervention has the potential to reduce the risk of family conflict, enhance collaborative family teamwork, and improve diabetes outcomes
This paper describes the study design and protocol for the Type 1 Doing Well pilot intervention study, which aims to address the need for brief, low-burden, and translatable behavioral interventions to facilitate positive family interactions and strengthen resilient diabetes outcomes during the challenging adolescent period
Summary
Background and RationaleType 1 diabetes (T1D) is one of the most common pediatric chronic conditions [1]: between 2001 and 2009, the prevalence among people under 20 years of age in the United States approached 1 in 500 youths. Difficulties with self-management and elevated glycemic outcomes are common during adolescence [3,4], when youths are often expected to take increasing responsibility for daily management [5,6]. Supportive parent involvement promotes optimal diabetes outcomes [7], yet maintaining positive, collaborative parent-adolescent interactions can be challenging in the context of normative adolescent development and diabetes-related stressors. Many families describe escalating conflict and difficulty in working together for T1D management [8,9], which increases the risk for poor clinical, behavioral, and glycemic outcomes [10,11]. Few interventions have used explicitly strengths-based approaches to help reinforce desired management behaviors and promote positive family interactions around diabetes care
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