title: An internet-based program to improve self-management in adolescents with type 1 diabetes.
abstract: OBJECTIVE To report results from YourWay, an Internet-based self-management intervention for adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 72 adolescents with type 1 diabetes, ages 13-17 years, were randomized to a usual-care-plus-Internet support or a usual-care group. The intervention was designed to enhance problem-solving barriers to self-management. A1C was obtained from medical records, and problem-solving and self-management were obtained via adolescent report. RESULTS Group differences were not statistically significant using intent-to-treat analyses. Using as-treated analyses, adolescents in the treatment condition showed statistically significant improvement in self-management (d = 0.64; P = 0.02) and important improvements in problem-solving (d = 0.30; P = 0.23) and A1C (d = -0.28; P = 0.27). Mean A1C for the intervention group remained constant (-0.01%), while the control group increased (0.33%). CONCLUSIONS This brief trial suggests that self-management support delivered through a secure website may improve self-management and offset typical decreases in adolescent glycemic control.
authors.affiliation: School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee, USA. shelagh.mulvaney@vanderbilt.edu
authors.forename: Shelagh A
authors.initials: SA
authors.lastname: Mulvaney
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
authors.forename: Cindy
authors.initials: C
authors.lastname: Lybarger
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology; D016497:Adolescent Health Services; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D007407:Interviews as Topic; D010349:Patient Compliance / Q000706:statistics & numerical data; D011340:Problem Solving / Q000502:physiology; D012648:Self Care / Q000379:methods*; D012657:Self-Help Groups
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human