An Intervention to Reduce Hypoglycemia Fear in Parents of Young Kids with Type 1 Diabetes Through Video-Based Telemedicine (REDCHiP): Trial Design, Feasibility, and Acceptability
An Intervention to Reduce Hypoglycemia Fear in Parents of Young Kids with Type 1 Diabetes Through Video-Based Telemedicine (REDCHiP): Trial Design, Feasibility, and Acceptability
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DOI：
10.1089/dia.2019.0244
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发表时间：
2019-11-13
影响因子：
5.4
通讯作者：
Patton, Susana R.
中科院分区：
文献类型：
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作者：
Marker, Arwen M.;Monzon, Alexandra D.;Patton, Susana R.
背景资料：对低血糖的恐惧（FH）在1型糖尿病（T1 D）幼儿的父母中很常见，并且与避免低血糖的适应不良行为，养育压力和倦怠有关。本研究探讨了一种新的基于组的远程医疗干预的可行性和可接受性，以减少FH的T1 D幼儿的父母。材料与方法：43个患有T1 D的幼儿（1-6岁;诊断为T1 D至少6个月）的家庭参加了这项研究，36个家庭完成了减少父母儿童抑郁症的情绪困扰（REDCHiP）干预。我们评估了干预的可行性与率的流失，干预出勤率，并忠实于治疗手册。我们通过治疗满意度调查和定性访谈（来自完成者子集; n=10）评估了干预可接受性、促进者和挑战的可接受性。结果：研究损耗为21%，包括长期随访（治疗期前或治疗期间为16%）。平均而言，父母参加了94%的干预会议，对治疗手册的忠诚度为89%。干预完成者对治疗组的满意度很高（平均满意度为89%）。父母报告的积极影响因素的REDCHiP干预增加知识，恐惧意识，应对策略，信心，行为养育策略和支持，而干预的挑战包括感到恐惧或不知所措，家庭压力，缺乏信任，以及难以与其他小组成员联系。结论：REDCHiP干预初步证明了可行性和可接受性。接下来的步骤包括确定干预措施对父母和孩子客观结果的影响（例如，血糖控制、父母FH和父母压力/痛苦）以及大规模功效测试。
Background: Fear of hypoglycemia (FH) is common in parents of young children with type 1 diabetes (T1D) and problematically linked to maladaptive behaviors to avoid low blood glucose, parenting stress, and burnout. This study examined the feasibility and acceptability of a novel group-based telemedicine intervention to reduce FH in parents of young children with T1D. Materials and Methods: Forty-three families of a young child with T1D (1-6 years of age; diagnosed with T1D for at least 6 months) enrolled in the study and 36 completed the Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP) intervention. We assessed intervention feasibility with rates of attrition, intervention attendance, and fidelity to the treatment manual. We assessed acceptability with treatment satisfaction surveys and qualitative interviews (from a subset of completers; n=10) about intervention acceptability, facilitators, and challenges. Results: Study attrition was 21%, including long-term follow-up (16% before or during the treatment phase). On average, parents attended 94% of intervention sessions and fidelity to the treatment manual was 89%. Intervention completers reported high satisfaction with the treatment groups (89% average satisfaction rating). Parent-reported positive influencers of the REDCHiP intervention were increased knowledge, fear awareness, coping strategies, confidence, behavioral parenting strategies, and support, whereas intervention challenges included feeling fearful or overwhelmed, family stress, lack of trust, and difficulty connecting with other group members. Conclusions: The REDCHiP intervention demonstrated initial feasibility and acceptability. Next steps include determining the intervention's impact on objective parent and child outcomes (e.g., glycemic control, parental FH, and parental stress/distress) as well as large-scale efficacy testing.