Ellis Deborah A, Idalski Carcone April, Ondersma Steven J, Naar-King Sylvie, Dekelbab Bassem, Moltz Kathleen
1 Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine , Detroit, Michigan.
2 Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine , Detroit, Michigan.
Telemed J E Health. 2017 Jun;23(6):493-502. doi: 10.1089/tmj.2016.0182. Epub 2017 Jan 6.
African American adolescents with type 1 diabetes (T1D) are at elevated risk for poor diabetes management and metabolic control. Parental supervision and monitoring of adolescent diabetes management have been shown to promote better diabetes management among adolescents, but parents typically decrease their oversight during the transition to independent diabetes care.
The purpose of the study was to conduct a randomized clinical trial to test the feasibility and efficacy of a three-session, computer-delivered motivational intervention (The 3Ms) to promote increased parental monitoring among primary caregivers of young African American adolescents with T1D. The intervention was brief and optimized for delivery during routine diabetes clinic visits.
Sixty-seven adolescents with T1D aged 11-14 and their primary caregiver were randomly assigned to one of three arms: adolescent and parent motivational intervention (Arm 1), adolescent control and parent motivational intervention (Arm 2), or adolescent and parent control (Arm 3). Intervention effects were assessed 1 month after intervention completion.
Parents in Arm 1 and Arm 2 had significant increases in knowledge of the importance of monitoring adolescents' diabetes care. Parents in Arm 2 also had trend to significant increases in direct observation and monitoring of adolescent diabetes care, and adolescents in Arm 2 had significant improvements in glycemic control.
Findings from the present study provide preliminary support for the efficacy of a brief, computer-delivered parenting intervention for improving family management practices and adolescent health outcomes among African American adolescents with T1D and their caregivers.
患有1型糖尿病(T1D)的非裔美国青少年面临糖尿病管理不善和代谢控制不佳的风险增加。父母对青少年糖尿病管理的监督已被证明能促进青少年更好地管理糖尿病,但在向独立糖尿病护理过渡期间,父母通常会减少监督。
本研究的目的是进行一项随机临床试验,以测试为期三阶段、通过计算机提供的动机干预(3Ms)的可行性和有效性,该干预旨在促进患有T1D的年轻非裔美国青少年的主要照顾者增加对他们的监督。该干预很简短,并针对在常规糖尿病门诊就诊期间进行提供进行了优化。
67名年龄在11 - 14岁之间患有T1D的青少年及其主要照顾者被随机分配到三个组之一:青少年和父母动机干预组(第1组)、青少年对照组和父母动机干预组(第2组)、或青少年和父母对照组(第3组)。在干预完成后1个月评估干预效果。
第1组和第2组的父母在了解监督青少年糖尿病护理重要性方面有显著增加。第2组的父母在直接观察和监督青少年糖尿病护理方面也有显著增加的趋势,并且第2组的青少年在血糖控制方面有显著改善。
本研究结果为一种简短的、通过计算机提供的育儿干预在改善患有T1D的非裔美国青少年及其照顾者的家庭管理实践和青少年健康结果方面的有效性提供了初步支持。