title: An internet coping skills training program for youth with type 1 diabetes: six-month outcomes.
abstract: BACKGROUND
  Managing Type 1 diabetes (T1D) during adolescence can be challenging, and there is a need for accessible interventions to help adolescents cope with diabetes-related stress.
  
  
  OBJECTIVE
  The aim of this study was to compare an Internet coping skills training (TEENCOPE) intervention to an Internet educational intervention (Managing Diabetes) for adolescents with T1D. Moderators of program efficacy were evaluated.
  
  
  METHODS
  The study was a multisite clinical trial (n = 320) with data collected at baseline, 3 months, and 6 months. Data were collected on the primary outcomes of physiologic (A1C) and psychosocial (quality of life) and on the secondary outcomes of behavioral (self-management) and psychosocial (stress, coping self-efficacy, social competence, family conflict) variables consistent with the conceptual framework. Data were analyzed using mixed-model analyses with an intent-to-treat approach.
  
  
  RESULTS
  There were no significant between-group treatment effects 6 months postintervention on primary outcomes. The Managing Diabetes youth showed a significant increase in social competence compared to the TEENCOPE youth. There were significant time effects for TEENCOPE (decreased stress and increased coping) and Managing Diabetes (improved diabetes quality of life).
  
  
  CONCLUSIONS
  Youth with T1D transitioning to adolescence may need both structured diabetes education and coping skills to improve health outcomes. There may be a higher potential to reach adolescents with Type 1 diabetes of varying race and ethnicity via Internet interventions.
authors.affiliation: School of Nursing, Yale University, New Haven, Connecticut, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Whittemore
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Jaser
authors.forename: Sangchoon
authors.initials: S
authors.lastname: Jeon
authors.forename: Lauren
authors.initials: L
authors.lastname: Liberti
authors.forename: Alan
authors.initials: A
authors.lastname: Delamater
authors.forename: Kathleen
authors.initials: K
authors.lastname: Murphy
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Faulkner
authors.forename: Margaret
authors.initials: M
authors.lastname: Grey
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D012648:Self Care; D013997:Time Factors; D016896:Treatment Outcome