title: Effects of behavioral family systems therapy for diabetes on adolescents' family relationships, treatment adherence, and metabolic control.
abstract: BACKGROUND
  Behavioral family systems therapy (BFST) for adolescents with diabetes has improved family relationships and communication, but effects on adherence and metabolic control were weak. We evaluated a revised intervention, BFST for diabetes (BFST-D).
  
  
  METHODS
  One hundred and four families were randomized to standard care (SC) or to 12 sessions of either an educational support group (ES) or a BFST-D over 6 months. Family relationships, adherence, glycosylated hemoglobin (HbA1c), and health care utilization were measured at baseline and after treatment.
  
  
  RESULTS
  BFST-D significantly improved family conflict and adherence compared to SC and ES, especially among those with baseline HbA1c > or = 9.0%. BFST-D and ES significantly improved HbA1c compared to SC among those with baseline HbA1c > or = 9.0%.
  
  
  CONCLUSIONS
  The revised intervention (BFST-D) improved family conflict and treatment adherence significantly, while both ES and BFST-D reduced HbA1c significantly, particularly among adolescents with poor metabolic control. Clinical translation of BFST-D requires further study.
authors.affiliation: Center for Pediatric Psychology Research, Nemours Children's Clinic, 807 Children's Way, Jacksonville, Florida 32207, USA. twysocki@nemours.org
authors.forename: Tim
authors.initials: T
authors.lastname: Wysocki
authors.forename: Michael A
authors.initials: MA
authors.lastname: Harris
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Buckloh
authors.forename: Deborah
authors.initials: D
authors.lastname: Mertlich
authors.forename: Amanda Sobel
authors.initials: AS
authors.lastname: Lochrie
authors.forename: Alexandra
authors.initials: A
authors.lastname: Taylor
authors.forename: Michelle
authors.initials: M
authors.lastname: Sadler
authors.forename: Nelly
authors.initials: N
authors.lastname: Mauras
authors.forename: Neil H
authors.initials: NH
authors.lastname: White
mesh_terms: D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005190:Family; D005195:Family Relations; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D010287:Parent-Child Relations; D010349:Patient Compliance; D012648:Self Care; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents