Harold Schnitzer Diabetes Health Center, Portland, OR Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR
Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR.
Diabetes Care. 2015 Aug;38(8):1427-34. doi: 10.2337/dc14-2469. Epub 2015 Jun 1.
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.
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.
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.
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.
本研究旨在比较两种行为家庭系统疗法治疗糖尿病（BFST-D）模式的相对有效性，以改善血糖控制不佳（HbA（1c）≥9.0%[≥74.9mmol/mol]）的 1 型糖尿病青少年的依从性和血糖控制：面对面诊所（诊所）和互联网视频会议（Skype）条件。
12 至 18 岁的青少年和至少一名成年照顾者被随机分配接受诊所或 Skype 条件下的 BFST-D。参与者在 12 周内完成多达 10 次治疗课程。在干预前后和随访评估时比较青少年和父母报告的依从性和血糖控制的变化。
采用意向治疗分析方法，未发现组间在基线、干预后和随访评估之间存在显著差异。将组合并以检查 BFST-D 对依从性和血糖控制的总体影响。结果表明，从干预前到干预后，依从性和血糖控制均显著改善；在 3 个月随访时仍保持改善。
通过基于互联网的视频会议提供 BFST-D 对于解决 1 型糖尿病青少年的不依从和血糖控制不佳是可行的，可能减少了对青年和家庭护理的重要障碍。
