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Feldman MA, Anderson LM, Shapiro JB, Jedraszko AM, Evans M, Weil LEG, Garza KP, Weissberg-Benchell J. Family-Based Interventions Targeting Improvements in Health and Family Outcomes of Children and Adolescents with Type 1 Diabetes: a Systematic Review. Curr Diab Rep 2018; 18:15. [PMID: 29457190 DOI: 10.1007/s11892-018-0981-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW A systematic review was conducted of family-based interventions to improve glycemic control, adherence, and psychosocial outcomes in children and adolescents with type 1 diabetes (T1D). Electronic databases were searched for randomized controlled trials (RCTs) published since the seminal Diabetes Control and Compliance Trial (DCCT). Interventions are summarized and findings reviewed to help guide clinical practice and future research. RECENT FINDINGS Twenty-five RCTs are reviewed. The majority of studies (n = 15) focused on interventions targeting both children and adolescents and their caregivers and were delivered in diabetes clinics, outpatient settings, mental health clinics, or participants' homes. Family-based interventions for youth with T1D appear effective at improving diabetes and family-centered outcomes. Additional research is needed to examine the pathways to improvement in glycemic control, as outcomes were mixed. Future research should also involve measures beyond HbA1c given new markers for sustained health improvement and outcomes are being explored.
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Affiliation(s)
- Marissa A Feldman
- Child Development and Rehabilitation Center, Johns Hopkins All Children's Hospital, 880 Sixth Street South, Suite 420, Saint Petersburg, FL, 33701, USA.
| | - Lindsay M Anderson
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Aneta M Jedraszko
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Meredyth Evans
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Lindsey E G Weil
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kimberly P Garza
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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2
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Psychoeducational interventions to improve adolescents’ medical management of diabetes: A comprehensive review. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.70357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fisher EB, Thorpe CT, McEvoy DeVellis B, DeVellis RF. Healthy Coping, Negative Emotions, and Diabetes Management. DIABETES EDUCATOR 2016; 33:1080-103; discussion 1104-6. [DOI: 10.1177/0145721707309808] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Edwin B. Fisher
- Department of Health Behavior and Health Education,
School of Public Health, University of North Carolina at Chapel Hill,
| | - Carolyn T. Thorpe
- Center for Health Services Research in Primary Care,
Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Brenda McEvoy DeVellis
- Department of Health Behavior and Health Education,
School of Public Health, University of North Carolina at Chapel Hill
| | - Robert F. DeVellis
- Department of Health Behavior and Health Education,
School of Public Health, University of North Carolina at Chapel Hill
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4
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Harris MA, Oelbaum R, Flomo D. State of the Art Reviews: Changing and Adhering to Lifestyle Changes. Am J Lifestyle Med 2016. [DOI: 10.1177/1559827606298979] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Given the relationship between lifestyle and health, researchers have examined those factors that predict healthy lifestyle changes. Several key variables have emerged from the literature, and these variables predict positive lifestyle changes across multiple health domains. More specifically, past health behavior, demographics, personality traits, social support, family functioning, ongoing contact with health care providers, and an individual's social ecology or network predict lifestyle change and adherence to lifestyle interventions. These variables are significant predictors of dietary and exercise regimen adherence, smoking cessation, decreased alcohol consumption, and adherence to medical treatment regimens. In addition, the use of behavioral, multicomponent, culturally specific interventions has proven to yield positive lifestyle changes across multiple health domains. For reasons of brevity, this review focuses on predictors of positive lifestyle change within the realms of diet and physical activity.
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Affiliation(s)
- Michael A. Harris
- Child Development and Rehabilitation Center, Oregon Health & Sciences University, Portland, Oregon,
| | - Rhea Oelbaum
- Patient Oriented Research Unit, Washington University School of Medicine, St Louis, Missouri
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Abstract
Diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM). This article examines the factors associated with DKA in children with T1DM, both at first presentation and in recurrent cases. The challenge for future research is to find effective ways to improve primary care physician and general community awareness of T1DM to reduce DKA at presentation and develop practical, cost-effective programs to reduce recurrent DKA.
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Affiliation(s)
- Craig A Jefferies
- Paediatric Endocrinology Service, Starship Children's Hospital, Auckland District Health Board, 2 Park Road, Auckland, 1023, New Zealand; Liggins Institute, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.
| | - Meranda Nakhla
- Department of Paediatrics, Montreal Children's Hospital, McGill University, 2300 Tupper Street, H3H 1P3, Montreal, Canada
| | - José G B Derraik
- Liggins Institute, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand
| | - Alistair J Gunn
- Paediatric Endocrinology Service, Starship Children's Hospital, Auckland District Health Board, 2 Park Road, Auckland, 1023, New Zealand; Department of Physiology, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand
| | - Denis Daneman
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, Canada
| | - Wayne S Cutfield
- Paediatric Endocrinology Service, Starship Children's Hospital, Auckland District Health Board, 2 Park Road, Auckland, 1023, New Zealand; Liggins Institute, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand
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Christie D. Current recommendations and considerations for psychosocial and psychoeducational support of adolescents with Type 1 diabetes. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/dmt.12.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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An internet coping skills training program for youth with type 1 diabetes: six-month outcomes. Nurs Res 2013; 61:395-404. [PMID: 22960587 DOI: 10.1097/nnr.0b013e3182690a29] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Managing Type 1 diabetes (T1D) during adolescence can be challenging, and there is a need for accessible interventions to help adolescents cope with diabetes-related stress. OBJECTIVES The aim of this study was to compare an Internet coping skills training (TEENCOPE) intervention to an Internet educational intervention (Managing Diabetes) for adolescents with T1D. Moderators of program efficacy were evaluated. METHODS The study was a multisite clinical trial (n = 320) with data collected at baseline, 3 months, and 6 months. Data were collected on the primary outcomes of physiologic (A1C) and psychosocial (quality of life) and on the secondary outcomes of behavioral (self-management) and psychosocial (stress, coping self-efficacy, social competence, family conflict) variables consistent with the conceptual framework. Data were analyzed using mixed-model analyses with an intent-to-treat approach. RESULTS There were no significant between-group treatment effects 6 months postintervention on primary outcomes. The Managing Diabetes youth showed a significant increase in social competence compared to the TEENCOPE youth. There were significant time effects for TEENCOPE (decreased stress and increased coping) and Managing Diabetes (improved diabetes quality of life). DISCUSSION Youth with T1D transitioning to adolescence may need both structured diabetes education and coping skills to improve health outcomes. There may be a higher potential to reach adolescents with Type 1 diabetes of varying race and ethnicity via Internet interventions.
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Song M, Deatrick JA, Feetham SL, Levin A. A Review of Diabetes Mellitus–Specific Family Assessment Instruments. West J Nurs Res 2011; 35:405-33. [DOI: 10.1177/0193945911413909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Family dynamics and attributes are increasingly recognized as affecting management of diabetes mellitus (DM); however, little research has been done on the validity and usefulness of family assessment instruments (FAIs). This article reviewed the literature that employs DM-specific FAIs and evaluates whether the instruments comprehensively captured family attributes/processes and were robust enough to be useful in understanding the relationship between family attributes/issues and DM-related health care. Studies using eight instruments were identified through a search of literature published from 1982 to 2010 and were analyzed with criteria derived from the measurement and family literatures. The findings of this study revealed that DM-specific FAIs yield useful data about family-related phenomenon; however, some domains of DM-specific care, such as family dynamics/functioning, were not overtly measured. Suggestions for improving DM-specific FAIs are provided and a rationale for why DM-specific and non-DM-specific FAIs is needed to fully measure family issues related to family dynamics/attributes on DM patient care.
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Affiliation(s)
- MinKyoung Song
- University of Pennsylvania School of Nursing, Philadelphia
| | | | - Suzanne L. Feetham
- University of Wisconsin–Milwaukee
- Children’s National Medical Center, Washington, DC
| | - Amy Levin
- University of Pennsylvania School of Nursing, Philadelphia
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Grey M, Jaser SS, Whittemore R, Jeon S, Lindemann E. Coping skills training for parents of children with type 1 diabetes: 12-month outcomes. Nurs Res 2011; 60:173-81. [PMID: 21522034 PMCID: PMC3134246 DOI: 10.1097/nnr.0b013e3182159c8f] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although it is recognized that caring for a child with Type 1 diabetes (T1D) is stressful for parents, few interventions have been developed and tested for this population. OBJECTIVES The aim of this study was to compare a group educational intervention for parents of children with T1D to a coping skills training intervention. METHODS Parents of children with T1D were randomized to the group educational (n = 106) or coping skills training (n = 75) conditions. Parents completed measures of family conflict, responsibility for treatment, coping, and quality of life at baseline and at 3, 6, and 12 months postintervention. Clinical data (i.e., HbA1c) were collected from children's medical records preintervention and postintervention. RESULTS There were no significant treatment effects 12 months postintervention, but parents in both groups reported improved coping (p < .001), less responsibility for treatment management (p < .001), and improved quality of life (p = .005). While children's metabolic control worsened over time, mean values at 12 months were still within the recommended levels in this well-controlled sample (HbA1c <8%). DISCUSSION Group-based interventions for parents of children with T1D may lessen the impact of treatment management, improving coping and quality of life.
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Affiliation(s)
- Margaret Grey
- School of Nursing, Yale University, New Haven, Connecticut 06536, USA
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Harris MA, Freeman KA, Duke DC. Getting (the most) out of the research business: interventions for youth with T1DM. Curr Diab Rep 2010; 10:406-14. [PMID: 20821285 DOI: 10.1007/s11892-010-0142-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We review research on psychosocial interventions to improve outcomes for youth with type 1 diabetes mellitus. Specifically, we discuss individual- and small group-focused, family-focused, group-focused, and other interventions. After reviewing extant research in each area, we discuss how the current evidence base may be used to inform clinical practice. Finally, we conclude by discussing variations in effects of interventions on different outcomes (eg, glycemic control, family functioning) and how to consider this evidence when selecting treatments to transport into clinical settings.
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Affiliation(s)
- Michael A Harris
- Pediatrics and Psychiatry, Division of Psychology, Child Development & Rehabilitation Center, Oregon Health & Science University, 707 SW Gaines, Portland, OR 97239, USA
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Harris MA, Freeman KA, Beers M. Family therapy for adolescents with poorly controlled diabetes: initial test of clinical significance. J Pediatr Psychol 2009; 34:1097-107. [PMID: 19264879 PMCID: PMC2773532 DOI: 10.1093/jpepsy/jsp009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 01/27/2009] [Accepted: 01/28/2009] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE We examined a structured family therapy approach in promoting clinically meaningful improvements in parent-adolescent conflict in adolescents with poorly controlled diabetes. METHOD Eighteen adolescents with poorly controlled diabetes and their parent(s) participated in 10 sessions of home-based Behavioral Family Systems Therapy (BFST). Outcome comparisons were made using a sample of adolescents with poorly controlled diabetes (n = 40) from a previous study. Clinically significant improvements were determined by calculating SD differences between treatment and comparison groups on measures of diabetes-related and general parent-adolescent conflict. RESULTS Home-based BFST produced change in diabetes-related family conflict ranging from 1/3 to 1/2 SD and general family conflict ranging from 1/3 to 3/4 SD. CONCLUSIONS BFST produced change in family conflict, a variable shown through previous research to relate to treatment adherence in adolescents with diabetes. The test of clinical significance represents an example of a method useful for pediatric research.
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Affiliation(s)
- Michael A Harris
- Department of Pediatrics/CDRC, Oregon Health & Science University, Portland, OR 97239, USA.
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Graves MM, Roberts MC, Rapoff M, Boyer A. The efficacy of adherence interventions for chronically ill children: a meta-analytic review. J Pediatr Psychol 2009; 35:368-82. [PMID: 19710248 DOI: 10.1093/jpepsy/jsp072] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To provide quantitative information about the overall effectiveness of adherence interventions to improve adherence and health outcomes for children with chronic illnesses. To evaluate statistically the potential moderators. METHODS A meta-analysis was performed on 71 adherence intervention studies. RESULTS Weighted-mean effect size (ES) across all the adherence outcomes for group design studies was in the medium range (mean d = 0.58) and for single-subject design studies was in the large range (mean d = 1.44). The weighted mean ES across all health outcome measures for studies using group designs was in the medium range (mean d = 0.40) and for studies using single-subject designs was in the large range (mean d = 0.74). CONCLUSIONS Adherence interventions for children with chronic illnesses effectively increase adherence and result in some positive health benefits. Intervention and methodological variables had significant impact on ESs. High levels of heterogeneity characterized the data.
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Dashiff C, Hardeman T, McLain R. Parent–adolescent communication and diabetes: an integrative review. J Adv Nurs 2008; 62:140-62. [DOI: 10.1111/j.1365-2648.2007.04549.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Anderson BJ, Svoren B, Laffel L. Initiatives to Promote Effective Self-Care Skills in Children and Adolescents with Diabetes Mellitus. ACTA ACUST UNITED AC 2007. [DOI: 10.2165/00115677-200715020-00005] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Greening L, Stoppelbein L, Reeves CB. A Model for Promoting Adolescents' Adherence to Treatment for Type 1 Diabetes Mellitus. CHILDRENS HEALTH CARE 2006. [DOI: 10.1207/s15326888chc3503_4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Drotar D. Commentary: revising behavioral family systems therapy to enhance treatment adherence and metabolic control in adolescents with type 1 diabetes. J Pediatr Psychol 2006; 31:939-44. [PMID: 16510771 DOI: 10.1093/jpepsy/jsj105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dennis Drotar
- Rainbow Babies and Children's Hospital, Case western Reserve University School of Medicine, USA.
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