title: Telehealth behavior therapy for the management of type 1 diabetes in adolescents.
abstract: BACKGROUND
  Poor management of type 1 diabetes mellitus (T1DM) may result in serious medical complications. Psychological intervention may improve adherence to medical regimens; however, access to trained professionals is limited, particularly in rural communities. Telehealth interventions may address this by allowing families to access services at home; however, little is known about the efficacy of such services.
  
  
  METHODS
  This study presents results from a pilot trial of a randomized waitlist controlled trial of Telehealth Behavioral Therapy (TBT) for youths with T1DM. Primary outcome measures were adherence to the diabetes regimen, glycemic control, and level of family discord. Thirty-two youths (23 female) with T1DM (aged 9 to 17 years) and one parent or caregiver participated. Telehealth Behavioral Therapy sessions were conducted thrice weekly for 12 weeks by phone and lasted an average of 15 min each.
  
  
  RESULTS
  Results indicated that youths in treatment decreased their hemoglobin A1c by 0.74 compared to 0.09 in the waitlist, though this was not statistically significant. Youths in treatment reported increased unsupportive and decreased caring parental behaviors.
  
  
  CONCLUSIONS
  Telehealth Behavioral Therapy improves access to knowledgeable providers and results in a clinically significant improvement in glycemic control. Despite some youths experiencing an increase in unsupportive parental behaviors, TBT is a promising method of service delivery that warrants further investigation.
authors.affiliation: Department of Psychology, Nationwide Children's Hospital, Columbus, Ohio 43205, USA. Heather.Lehmkuhl@NationwideChildrensHospital.org
authors.forename: Heather D
authors.initials: HD
authors.lastname: Lehmkuhl
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
authors.forename: Christina
authors.initials: C
authors.lastname: Cammarata
authors.forename: Kara
authors.initials: K
authors.lastname: Meyer
authors.forename: Omar
authors.initials: O
authors.lastname: Rahman
authors.forename: Janet
authors.initials: J
authors.lastname: Silverstein
authors.forename: Toree
authors.initials: T
authors.lastname: Malasanos
authors.forename: Gary
authors.initials: G
authors.lastname: Geffken
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology; D001521:Behavior Therapy / Q000379:methods*; D017028:Caregivers; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010290:Parents; D010865:Pilot Projects; D012923:Social Class; D017216:Telemedicine / Q000379:methods; D014850:Waiting Lists
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human