Flores Garcia Jaquelin, Reid Mark W, Torres Sanchez Alejandra, Ruelas Valerie, Salvy Sarah-Jeanne, Thomas Alex, Ashwal Gary, Fox D Steven, Raymond Jennifer K
Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
Division of Endocrinology, Keck School of Medicine of USC, Los Angeles, CA 90033, USA.
Children (Basel). 2024 Nov 14;11(11):1383. doi: 10.3390/children11111383.
Despite advancements in T1D care regimens, racially and ethnically diverse youth with low income continue to experience worse health outcomes, more psychosocial challenges, and higher barriers to care. Alternative care models are needed to address the needs of this population.
Team Clinic is a person-centered virtual peer group (VPG) care model that was assessed in a 15-month, pragmatic randomized controlled trial. Youth (ages 10-17) and their families were assigned to study arms based on their clinician's group (standard care or person-centered care, PCC) and then randomized to VPGs or no groups.
Data from 79 youth and their families were examined. While positive outcomes were seen across all study groups, youth that participated in Team Clinic (PCC + VPG) reported the largest increases in resilience at the end of the study (+7.42, to 51.63, = 0.009). These participants also reported the lowest levels of depressive symptoms as assessed by PHQ-8 scores (-5.07, = 0.002) at the end of the study.
Team Clinic can serve as an alternative care model for racially and ethnically diverse youth with T1D and their families. VPGs can provide unique benefits, including an increase in resilience, a decrease in depressive symptoms, and a safe space for families to connect, learn, and receive support.
尽管1型糖尿病(T1D)护理方案有所进步,但低收入的不同种族和族裔的青少年仍然面临更差的健康状况、更多的心理社会挑战以及更高的护理障碍。需要替代性护理模式来满足这一人群的需求。
团队诊所是一种以患者为中心的虚拟同伴小组(VPG)护理模式,在一项为期15个月的实用随机对照试验中进行了评估。青少年(10 - 17岁)及其家庭根据其临床医生所在的组(标准护理或以患者为中心的护理,PCC)被分配到研究组,然后随机分为VPG组或非VPG组。
对79名青少年及其家庭的数据进行了检查。虽然在所有研究组中都观察到了积极的结果,但参与团队诊所(PCC + VPG)的青少年在研究结束时报告的复原力提升幅度最大(+7.42,达到51.63,P = 0.009)。这些参与者在研究结束时通过PHQ - 8评分评估的抑郁症状水平也最低(-5.07,P = 0.002)。
团队诊所可以作为患有T1D的不同种族和族裔青少年及其家庭的替代性护理模式。VPG可以提供独特的益处,包括提高复原力、减轻抑郁症状,以及为家庭提供一个连接、学习和获得支持的安全空间。