Telehealth behavior therapy for the management of type 1 diabetes in adolescents.
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.
Lehmkuhl
Heather D
HD
Department of Psychology, Nationwide Children's Hospital, Columbus, Ohio 43205, USA. Heather.Lehmkuhl@NationwideChildrensHospital.org
Storch
Eric A
EA
Cammarata
Christina
C
Meyer
Kara
K
Rahman
Omar
O
Silverstein
Janet
J
Malasanos
Toree
T
Geffken
Gary
G
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
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human