Pilot Study of a Web-Delivered Multicomponent Intervention for Rural Teens with Poorly Controlled Type 1 Diabetes.
Objective. The purpose of this study was to examine the feasibility and effectiveness of a web-delivered multicomponent behavioral and family-based intervention targeting self-regulation and self-monitoring of blood glucose levels (SMBG) and glycemic control (HbA1c) in teens with type 1 diabetes (T1DM) living in rural US. Methods. 15 teens with poorly controlled T1DM participated in a 25-week web-delivered intervention with two phases, active treatment (weekly treatment sessions and working memory training program) and maintenance treatment (fading of treatment sessions). Results. Almost all (13 of 15) participants completed at least 14 of 15 treatment sessions and at least 20 of 25 working memory training sessions. SMBG was increased significantly at end of active and maintenance treatment, and HbA1c was decreased at end of active treatment (p's ≤ 0.05). Executive functioning improved at end of maintenance treatment: performance on working memory and inhibitory control tasks significantly improved (p's ≤ 0.02) and parents reported fewer problems with executive functioning (p = 0.05). Improvement in inhibitory control was correlated with increases in SMBG and decreases in HbA1c. Conclusions. An innovative web-delivered and multicomponent intervention was feasible for teens with poorly controlled T1DM and their families living in rural US and associated with significant improvements in SMBG and HbA1c.
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH 03766, USA.
Amy Hughes
0000-0002-4603-3823
AH
Lansing
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH 03766, USA.
Catherine
0000-0003-2221-5232
C
Stanger
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH 03766, USA.
Alan
0000-0001-6308-6823
A
Budney
Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, USA.
Ann S
AS
Christiano
Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, USA.
Samuel J
SJ
Casella
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007266:Inhibition, Psychological; D007328:Insulin / Q000627:therapeutic use; D020407:Internet; D008297:Male; D008570:Memory, Short-Term; D062405:Motivational Interviewing / Q000379:methods*; D010865:Pilot Projects; D012424:Rural Population; D012648:Self Care; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human