title: Teaming up: feasibility of an online treatment environment for adolescents with type 1 diabetes.
abstract: OBJECTIVE
  To evaluate the feasibility of an online interactive treatment environment for adolescents with type 1 diabetes, called Sugarsquare, to supplement usual care.
  
  
  METHODS
  Sugarsquare provides easily accessible contact with the diabetes team, peer support, and treatment overview. Of 120 eligible patients, 62 adolescents aged 11-21 (M = 15.23, SD = 2.00) were assigned to a usual-care group (n = 31) or a usual-care + intervention group (n = 31). Feasibility was assessed in terms of acceptability, demand, practicability, integration, and efficacy in a 9-month study-period.
  
  
  RESULTS
  Assessment of acceptability and demand revealed that 20 adolescents in the intervention group (65%) logged in at least once; 16 adolescents (52%) logged in repeatedly. Usage resulted in 5795 page-views, 3580 chat-messages, 427 forum-messages, and in 40 private interactions between 11 adolescents (35%) and professionals. Assessment of practicability revealed that all 13 professionals (100%) accessed the intervention. Slow processing speed and security procedures formed obstacles for usage. Assessment of integration showed that international standards for diabetes care (International Diabetes Federation/International Society for Pediatric and Adolescent Diabetes/American Diabetes Association) were met. Assessment of efficacy revealed improvement in the intervention group in evaluation of care (Patients' Evaluation of Quality of Diabetes), F(1,30) = 5.35, p < 0.05, and quality of life, communication (PedsQL), F(1,30) = 11.65, p <0.05. The latter was correlated with posted chat-messages (r = 0.42, p < 0.05). No between-group differences were found.
  
  
  CONCLUSIONS
  This study shows that Sugarsquare is feasible in adolescents with type 1 diabetes. It meets a demand in adolescents and can support professionals when organizing on-going care according to international standards. Results are promising and next steps are a full-scale randomized controlled trial and subsequent implementation in daily care.
authors.affiliation: Department of Medical Psychology, Radboud university medical center, 6500 HE, Nijmegen, The Netherlands; Children's Diabetes Center Nijmegen, 6500 GS, Nijmegen, The Netherlands.
authors.forename: Emiel A
authors.initials: EA
authors.lastname: Boogerd
authors.forename: Cees
authors.initials: C
authors.lastname: Noordam
authors.forename: Jan Am
authors.initials: JA
authors.lastname: Kremer
authors.forename: Judith B
authors.initials: JB
authors.lastname: Prins
authors.forename: Chris M
authors.initials: CM
authors.lastname: Verhaak
mesh_terms: D000293:Adolescent; D002648:Child; D003142:Communication; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D020407:Internet; D010348:Patient Care Team; D010379:Peer Group; D011788:Quality of Life; D012648:Self Care
keywords: Internet; adolescents; diabetes mellitus, type 1; feasibility studies; quality of life