Internet psycho-education programs improve outcomes in youth with type 1 diabetes

Margaret Grey, Robin Whittemore, Sangchoon Jeon, Kathryn Murphy, Melissa S. Faulkner, Alan M Delamater

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

OBJECTIVE-The purpose of this study was to determine the efficacy of two Internet-based psycho-educational programs designed to improve outcomes for youth with type 1 diabetes transitioning to adolescence. RESEARCH DESIGN AND METHODS-The study was a multisite clinical trial of 320 youth (aged 11-14 years; 37% minority; 55% female) randomized to one of two Internet-based interventions: TeenCope or Managing Diabetes. Primary outcomes were HbA 1c and quality of life (QOL). Secondary outcomes included coping, self-efficacy, social competence, self-management, and family conflict. Data were collected at baseline and after 3, 6, and 12 months online. Youth were invited to cross over to the other program after 12 months, and follow-up data were collected at 18 months. Analyses were based on mixed models using intent-to-treat and perprotocol procedures. RESULTS-Youth in both groups had stable QOL and minimal increases in HbA1c levels over 12 months, but there were no significant differences between the groups in primary outcomes. After 18 months, youth who completed both programs had lower HbA1c (P = 0.04); higher QOL (P = 0.02), social acceptance (P = 0.01), and self-efficacy (P = 0.03) and lower perceived stress (P = 0.02) and diabetes family conflict (P = 0.02) compared with those who completed only one program. CONCLUSIONSdInternet interventions for youth with type 1 diabetes transitioning to adolescence result in improved outcomes, but completion of both programs was better than only one, suggesting that these youth need both diabetes management education and behavioral interventions. Delivering these programs via the Internet represents an efficient way to reach youth and improve outcomes.

Original languageEnglish
Pages (from-to)2475-2482
Number of pages8
JournalDiabetes Care
Volume36
Issue number9
DOIs
StatePublished - Sep 1 2013

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Type 1 Diabetes Mellitus
Internet
Education
Family Conflict
Quality of Life
Self Efficacy
Social Distance
Self Care
Research Design
Clinical Trials

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Internet psycho-education programs improve outcomes in youth with type 1 diabetes. / Grey, Margaret; Whittemore, Robin; Jeon, Sangchoon; Murphy, Kathryn; Faulkner, Melissa S.; Delamater, Alan M.

In: Diabetes Care, Vol. 36, No. 9, 01.09.2013, p. 2475-2482.

Research output: Contribution to journalArticle

Grey, M, Whittemore, R, Jeon, S, Murphy, K, Faulkner, MS & Delamater, AM 2013, 'Internet psycho-education programs improve outcomes in youth with type 1 diabetes', Diabetes Care, vol. 36, no. 9, pp. 2475-2482. https://doi.org/10.2337/dc12-2199
Grey, Margaret ; Whittemore, Robin ; Jeon, Sangchoon ; Murphy, Kathryn ; Faulkner, Melissa S. ; Delamater, Alan M. / Internet psycho-education programs improve outcomes in youth with type 1 diabetes. In: Diabetes Care. 2013 ; Vol. 36, No. 9. pp. 2475-2482.
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AB - OBJECTIVE-The purpose of this study was to determine the efficacy of two Internet-based psycho-educational programs designed to improve outcomes for youth with type 1 diabetes transitioning to adolescence. RESEARCH DESIGN AND METHODS-The study was a multisite clinical trial of 320 youth (aged 11-14 years; 37% minority; 55% female) randomized to one of two Internet-based interventions: TeenCope or Managing Diabetes. Primary outcomes were HbA 1c and quality of life (QOL). Secondary outcomes included coping, self-efficacy, social competence, self-management, and family conflict. Data were collected at baseline and after 3, 6, and 12 months online. Youth were invited to cross over to the other program after 12 months, and follow-up data were collected at 18 months. Analyses were based on mixed models using intent-to-treat and perprotocol procedures. RESULTS-Youth in both groups had stable QOL and minimal increases in HbA1c levels over 12 months, but there were no significant differences between the groups in primary outcomes. After 18 months, youth who completed both programs had lower HbA1c (P = 0.04); higher QOL (P = 0.02), social acceptance (P = 0.01), and self-efficacy (P = 0.03) and lower perceived stress (P = 0.02) and diabetes family conflict (P = 0.02) compared with those who completed only one program. CONCLUSIONSdInternet interventions for youth with type 1 diabetes transitioning to adolescence result in improved outcomes, but completion of both programs was better than only one, suggesting that these youth need both diabetes management education and behavioral interventions. Delivering these programs via the Internet represents an efficient way to reach youth and improve outcomes.

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