Type1diabetes Clinical Trial
Official title:
Type 1 Teamwork: A Tool for Parents of Adolescents With Type 1 Diabetes
Type 1 Diabetes (T1DM) is a common chronic illness in children which presents difficult and often stressful management concerns for parents. As children approach adolescence, this burden increases with the desire for independence and self-management. No tool exists that addresses in a user friendly, easy to access and socio-culturally appropriate way, the psychosocial needs of parents as they move through this transition. This program targets the parents to help them at the very point where this transition is occurring.
Type 1 diabetes (T1D) is one of the most common chronic illnesses in children, affecting 1 in
400,1 with evidence that its prevalence is increasing worldwide.2 The prevalence of T1D in
adolescents is approximately 70% White, 22% Hispanic, and 8% Black.3-5 Parents of children
with T1D are responsible for a labor-intensive and complicated daily regimen that has been
described as an overwhelming experience, requiring constant vigilance.6 Intensive management
of T1D requires frequent blood glucose monitoring, multiple insulin injections or use of an
insulin pump, frequent alterations in insulin dose to match changing diet and activity
patterns, and regular visits to health care providers. This 24/7 attention to their child's
health manifests in elevated rates of parental perception of stress and increased risk for
depression and anxiety. The prevalence of anxiety symptoms for parents of children with T1D
range from 21-59%; depressive symptoms from 10-74%; psychological distress from 29-33%; and
posttraumatic stress symptoms from 19-24%.7-9 Parental psychological distress has negative
health implications for the parent, the overall functioning of the family, the psychological
adjustment of their child with T1D, diabetes management, and child metabolic control.10-14
The goal of this application is to complete the psycho-educational web-based program for
parents of adolescents with T1D (Type1Teamwork) which will help to: 1) decrease parental
perceived stress and distress; 2) promote parental adjustment to the developmental
transitions in adolescence; 3) support adolescent autonomy and transfer of diabetes
responsibility from parent to adolescent; 4) decrease family conflict; and 5) maintain
metabolic control during adolescence. The investigators propose to complete two major Aims in
Phase II:
Specific Aim 1: Develop the Type1Teamwork program (for use on computer, tablet, or smart
phone) based on the activities completed in Phase I. Six content themes have been identified
as important to parents and providers. Feasibility assessment has provided support of these
content themes as well as substantive recommendations to ensure content and interactivity is
engaging and meets the needs of parents of children with T1D as well as health care
providers. The investigators will use an iterative process of development and evaluation,
collaborating with our technology team, parent advisors, and clinical consultants to ensure
development of a quality product and to submit a peer reviewed manuscript for publication of
the results.
Specific Aim 2: Evaluate the Type1Teamwork program through a modest randomized clinical
trial. The investigators will determine the effect of the program on parent psychosocial
outcomes (stress, depression, and anxiety), adolescent autonomy, parent-adolescent
responsibility for T1D management, family conflict, and adolescent metabolic control. Results
will be presented at diabetes meetings, published in top tier journals (to provide clinical
and scientific evidence of the newly developed program), and widely disseminated per the
commercialization and marketing plan.
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