Communication and Coping: Addressing Mothers' Needs to Improve Outcomes in Adolescents with T1D

沟通和应对：满足母亲的需求，改善 1D 青少年的预后

• 批准号: 10197112
• 负责人: Sarah Sanders Jaser
• 金额: $ 42.3万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-18 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10197112
• 关键词: Address; Adherence; Adolescent; Adult; Age; American; Behavior Therapy; Caregivers; Caring; Child; Child Rearing; Chronic Disease; Clinical; Cognitive Therapy; Communication; Complex; Conflict (Psychology); Demographic Factors; Diabetes Mellitus; Disease; Distress; Educational Materials; Educational process of instructing; Facebook; Family; Family member; Fibrinogen; Foundations; Goals; Impairment; Income; Individual; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Studies; Marital Status; Mediating; Mediator of activation protein; Mental Depression; Modeling; Monitor; Mothers; Outcome; Parents; Pilot Projects; Play; Population; Privatization; Quality of life; Randomized; Randomized Clinical Trials; Regimen; Reporting; Resources; Risk; Risk Factors; Role; Social support; Stress; Stress and Coping; Telephone; Testing; Therapeutic Intervention; Time; Work; Youth; acceptability and feasibility; attentional control; base; clinically significant; coping; depressive symptoms; diabetes management; effective intervention; efficacy evaluation; experience; glycemic control; high risk population; improved; improved outcome; innovation; intervention effect; meetings; novel; parental involvement; post intervention; programs; psychosocial; sex; skills; social media; stressor

ABSTRACT Mothers of adolescents with type 1 diabetes experience high levels of depressive symptoms, which impair their ability to monitor and manage diabetes treatment effectively. Given that adolescents are a high-risk population for suboptimal glycemic control – with only 17% meeting treatment goals - there is a critical need for novel interventions to improve outcomes in adolescents with T1D. Yet, previous behavioral interventions for youth with diabetes have not directly targeted maternal depressive symptoms. Building on effective interventions to treat depression in adults, and our own pilot work in this population, the proposed study will use a rigorous approach to evaluate the efficacy of a cognitive-behavioral intervention for mothers of adolescents with type 1 diabetes to promote the use of adaptive coping strategies and positive parenting practices. Results from our pilot study indicated significant intervention effects on adolescents’ quality of life and depressive symptoms. In addition, adolescents whose mothers received the intervention demonstrated promising improvements in glycemic control, and we found support for the effect of the intervention on mediating variables, with large effects on maternal depressive symptoms and family conflict. The revised aims of this study are to: 1) evaluate the effects of the Communication & Coping intervention on diabetes-related outcomes; 2) evaluate the effects of the Communication & Coping intervention on psychosocial outcomes; and 3) explore the differential impact of the intervention across demographic factors. Mothers who are randomized to the Communication & Coping Intervention will receive individual cognitive-behavioral therapy sessions by phone, as well as access to a Facebook group to augment the material covered in calls and provide social support. Mothers randomized to the Attention Control condition will receive educational materials and phone check-ins, as well as a Facebook group with educational posts. Adolescents and their mothers will be assessed at baseline and again post- intervention, at 3 months, 6 months, and 12 months. We hypothesize that the adolescents of mothers who receive the intervention will demonstrate improvements in diabetes outcomes (i.e., glycemic control, adherence), as well as psychosocial outcomes (i.e., improved quality of life, fewer depressive symptoms) compared to those in the attention control condition. This approach is innovative by targeting maternal depressive symptoms and the quality of parental involvement in mothers of adolescents with type 1 diabetes. Responding to the American Diabetes Association’s call to address the psychosocial needs of people with diabetes and their family members, the proposed project has the potential to improve outcomes in both adolescents with type 1 diabetes and their mothers.

抽象的 患有1型糖尿病的青少年的母亲会经历高水平的抑郁症状，这会损害他们的 有效监测和管理糖尿病治疗的能力。鉴于青少年是高风险人口 对于次优的血糖控制 - 只有17％的人满足治疗目标 - 对新颖的需求至关重要 干预措施以改善T1D青少年的结局。然而，以前针对青年的行为干预 糖尿病没有直接针对材料抑郁症状。以有效的干预为基础 治疗成人的抑郁症以及我们自己在这一人群中的飞行员工作，拟议的研究将使用严格的研究 评估认知行为干预效率的方法 糖尿病以促进适应性应对策略和积极的育儿实践的使用。我们的结果 试点研究表明，干预对青少年生活质量和抑郁症状的显着影响。在 此外，母亲接受干预措施的青少年证明了 血糖控制，我们发现了干预对中介变量的影响的支持， 对母亲抑郁症状和家庭冲突的影响。这项研究的修订目的是：1）评估 沟通和应对干预对与糖尿病相关的结果的影响； 2）评估效果 关于社会心理成果的沟通和应对干预； 3）探索差异影响 人口统计学因素的干预措施。随机进行交流和应对的母亲 干预将通过电话接受单独的认知行为治疗课程，并访问 Facebook Group增加了电话中涵盖的材料并提供社会支持。母亲随机 注意力控制条件将获得教育材料和电话检查，以及Facebook 小组带有教育职位。青少年及其母亲将在基线时进行评估，然后在 干预3个月，6个月和12个月。我们假设，母亲的青少年 接受干预将表明糖尿病预后的改善（即血糖控制， 依从性）以及社会心理结局（即改善生活质量，抑郁症状更少） 与注意力控制条件的人相比。这种方法是通过针对母体来创新的 抑郁症状和父母参与1型糖尿病的青少年母亲的质量。 回应美国糖尿病协会的呼吁，以满足患者的社会心理需求 糖尿病及其家人，拟议的项目有可能改善两者的预后 患有1型糖尿病的青少年及其母亲。