The science of intervention development for type 1 diabetes in childhood: systematic review.
OBJECTIVE
This paper is a report of a review of the science of intervention development for type 1 diabetes in childhood and its implications for improving health outcomes in children, adolescents, and/or their families.


BACKGROUND
Previous reviewers have identified insufficient evidence to support the application of effective interventions for type 1 diabetes in clinical practice. The need for quality randomized controlled trials to address shortcomings in previous study designs has been highlighted as a priority for future intervention research. However, there is also a need to consider the scientific development of interventions, which to date has received little attention.


METHODS
A search for published randomized controlled trials over 5 years (2004-2008) was conducted in electronic databases (Medline, CINAHL, Cochrane Library, Psychinfo, ERIC). Reference lists of papers identified from electronic searches were examined for additional papers.


METHODS
A systematic review was conducted. Studies were included if (i) an intervention for managing any aspect of type 1 diabetes was implemented, (ii) children, adolescents and/or their families were sampled, (iii) a randomized controlled trial, (iv) published in English.


RESULTS
Fourteen randomized controlled trials were reviewed on education (n = 7), psychosocial (n = 5) and family therapy (n = 2) interventions. Compared to education interventions, family therapy and most psychosocial interventions were developed with greater scientific rigour, and demonstrated promising effects on more health outcomes measured.


CONCLUSIONS
Interventions developed within clearly-defined scientific criteria offer potential for improving health outcomes in children and adolescents with type 1 diabetes and their families. Future reviews on interventions for type 1 diabetes in childhood need to include criteria for assessing the science of intervention development.
Savage
Eileen
E
 Catherine McAuley School of Nursing, Brookfield Health Science Complex, University College Cork, Cork, Ireland. e.savage@ucc.ie
Farrell
Dawn
D
McManus
Vicki
V
Grey
Margaret
M
D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D005192:Family Health; D005196:Family Therapy; D006801:Humans; D015399:Nursing Research; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D015397:Program Evaluation / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design / Q000592:standards; D055815:Young Adult