title: Seeing Is Believing: Using Skype to Improve Diabetes Outcomes in Youth.
abstract: OBJECTIVE
  The objective of this study was to compare the relative effectiveness of two modes of delivering Behavioral Family Systems Therapy for Diabetes (BFST-D) to improve adherence and glycemic control among adolescents with type 1 diabetes with suboptimal glycemic control (HbA(1c) ≥9.0% [≥74.9 mmol/mol]): face to face in clinic (Clinic) and Internet videoconferencing (Skype) conditions.
  
  
  METHODS
  Adolescents aged 12 to 18 years and at least one adult caregiver were randomized to receive BFST-D via the Clinic or Skype condition. Participants completed up to 10 therapy sessions within a 12-week period. Changes in youth- and parent-reported adherence and glycemic control were compared before and after the intervention and at follow-up assessment.
  
  
  RESULTS
  Using an intent-to-treat analytic approach, no significant between-group differences were identified between the before, after, and follow-up assessments. Groups were collapsed to examine the overall effects of BFST-D on adherence and glycemic control. Results identified that statistically significant improvements in adherence and glycemic control occurred from before to after the intervention; improvements were maintained at 3-month follow-up.
  
  
  CONCLUSIONS
  Delivery of BFST-D via Internet-based videoconferencing is viable for addressing nonadherence and suboptimal glycemic control in adolescents with type 1 diabetes, potentially reducing important barriers to care for youth and families.
authors.affiliation: Harold Schnitzer Diabetes Health Center, Portland, OR Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR harrismi@ohsu.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Harris
authors.affiliation: Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR.
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Freeman
authors.affiliation: Harold Schnitzer Diabetes Health Center, Portland, OR Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR.
authors.forename: Danny C
authors.identifier: http://orcid.org/0000-0002-1726-1149
authors.initials: DC
authors.lastname: Duke
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D001786:Blood Glucose / Q000032:analysis; D017028:Caregivers; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D049269:Videoconferencing
chemical_list: D001786:Blood Glucose