Internet Psycho-Education Programs Improve Outcomes in Youth With Type 1 Diabetes
Internet Psycho-Education Programs Improve Outcomes in Youth With Type 1 Diabetes
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DOI：
10.2337/dc12-2199
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发表时间：
2013-09-01
期刊：
影响因子：
16.2
通讯作者：
Delamater, Alan
中科院分区：
文献类型：
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作者：
Grey, Margaret;Whittemore, Robin;Delamater, Alan
目的 - 本研究的目的是确定两项基于互联网的心理教育计划的有效性，这些计划旨在改善 1 型糖尿病青少年过渡到青春期的结局。 研究设计和方法 - 该研究是一项多中心临床试验，对 320 名青少年（11-14 岁；37% 少数族裔；55% 女性）随机接受两种基于互联网的干预措施之一：TeenCope 或管理糖尿病。主要结局是 HbA(1c) 和生活质量 (QOL)。次要结果包括应对、自我效能、社交能力、自我管理和家庭冲突。数据是在基线以及 3、6 和 12 个月后在线收集的。 12 个月后，青少年被邀请跨入另一个项目，并在 18 个月时收集后续数据。分析基于使用意向治疗和符合方案程序的混合模型。 结果：12 个月内，两组青少年的生活质量稳定，HbA(1c) 水平略有增加，但各组之间的主要结局没有显着差异。 18 个月后，完成这两个项目的青少年的 HbA(1c) 较低（P = 0.04）；与仅完成一项计划的人相比，他们的生活质量（P = 0.02）、社会接受度（P = 0.01）和自我效能（P = 0.03）更高，感知压力（P = 0.02）和糖尿病家庭冲突（P = 0.02）更低。 结论：对于过渡到青春期的 1 型糖尿病青少年，互联网干预可以改善结果，但完成两个计划比只完成一个计划要好，这表明这些青少年需要糖尿病管理教育和行为干预。通过互联网提供这些计划是接触青年和改善成果的有效方式。
OBJECTIVE-The purpose of this study was to determine the efficacy of two Internet-based psycho-educational programs designed to improve outcomes for youth with type 1 diabetes transitioning to adolescence.RESEARCH DESIGN AND METHODS-The study was a multisite clinical trial of 320 youth (aged 11-14 years; 37% minority; 55% female) randomized to one of two Internet-based interventions: TeenCope or Managing Diabetes. Primary outcomes were HbA(1c) and quality of life (QOL). Secondary outcomes included coping, self-efficacy, social competence, self-management, and family conflict. Data were collected at baseline and after 3, 6, and 12 months online. Youth were invited to cross over to the other program after 12 months, and follow-up data were collected at 18 months. Analyses were based on mixed models using intent-to-treat and per-protocol procedures.RESULTS-Youth in both groups had stable QOL and minimal increases in HbA(1c) levels over 12 months, but there were no significant differences between the groups in primary outcomes. After 18 months, youth who completed both programs had lower HbA(1c) (P = 0.04); higher QOL (P = 0.02), social acceptance (P = 0.01), and self-efficacy (P = 0.03) and lower perceived stress (P = 0.02) and diabetes family conflict (P = 0.02) compared with those who completed only one program.CONCLUSIONS-Internet interventions for youth with type 1 diabetes transitioning to adolescence result in improved outcomes, but completion of both programs was better than only one, suggesting that these youth need both diabetes management education and behavioral interventions. Delivering these programs via the Internet represents an efficient way to reach youth and improve outcomes.