title: Use of Relational Agents to Improve Family Communication in Type 1 Diabetes: Methods.
abstract: BACKGROUND
  Physiological and environmental risk factors interact to undermine blood glucose control during early adolescence. This has been documented to be associated with family conflict and poor adherence to diabetes management tasks. Family Teamwork is an efficacious program demonstrated to enhance family communication and reduce conflict during this vulnerable period. It was designed to be delivered to families in-person, which limited reach and potential impact.
  
  
  OBJECTIVE
  The purpose of this paper is to present the protocol for adapting Family Teamwork for Web-based delivery.
  
  
  METHODS
  Formative research with health care providers, parents, and adolescents will help modify Family Teamwork for Web-based delivery by a relational agent (ie, a computerized character with human-like features and actions). Sessions will be interactive, requiring both parent and adolescent participation, with the relational agent serving as a health coach. After programming, usability testing will be conducted to help ensure the program is easy to use. Video and instructional materials will be developed to facilitate use, and a small pilot study will be conducted to assess feasibility. Families will provide written informed consent prior to participation in any phase of the study. The Institutional Review Board at Baylor College of Medicine reviewed and approved the protocol (H-37245).
  
  
  RESULTS
  Formative research is underway. No results are available at this time.
  
  
  CONCLUSIONS
  This research has the potential to make an important contribution to diabetes management by using technology to enhance the reach of an efficacious program.
authors.affiliation: USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States. dit@bcm.edu.
authors.forename: Debbe
authors.identifier: http://orcid.org/0000-0002-5491-8816
authors.initials: D
authors.lastname: Thompson
authors.forename: Karen W
authors.identifier: http://orcid.org/0000-0002-5114-6232
authors.initials: KW
authors.lastname: Cullen
authors.forename: Maria J
authors.identifier: http://orcid.org/0000-0001-5871-4645
authors.initials: MJ
authors.lastname: Redondo
authors.forename: Barbara
authors.identifier: http://orcid.org/0000-0003-1587-7967
authors.initials: B
authors.lastname: Anderson
keywords: adolescents; family communication; pre-adolescents; relational agent; type 1 diabetes