Integrating behavioral care for teens with diabetes

General Research Subject: Type 1 Diabetes

Focus: Health Care Delivery/Economics, Pediatrics\Type 1, Psychosocial Behavioral Medicine

Type of Grant: ADA-Sanofi-Aventis U.S Award in Health Services Research in Clinical Care Delivery

Project Start Date: January 1, 2012

Project End Date: December 31, 2014

Diabetes Type: Type 1 diabetes

Research Description

Teens with type 1 diabetes (T1D) are at higher risk for poorer metabolic control and psychosocial distress than younger youth or adults. In previous studies, educational programs that include content on stress management and coping skills have been shown to improve A1C and quality of life. Most of these programs are conducted in person and have been increasingly difficult to implement in practice. Since teens are high users of the internet (93%), programs that reach teens have been developed. These include Teens-Connect ™ (developed at Yale) and the ADA's Planet-D™. But, little work has been done to incorporate such interventions into clinical care. In this study, 120 youth (age 10-14) will be recruited to learn whether clinicians providing a prescription to use one of these programs lead to better A1C and quality of life after 6 months, while accounting for actual use. In addition to studying these outcomes, data will be collected on cost-effectiveness. This study has the potential to lead to wider availability of tested preventive diabetes programs in a format that is liked by teens. Ultimately, the results may lead to cost-effective delivery of such programs to adolescents with T1D.

Research Profile

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and or/curing diabetes?

Our project focuses on helping teens with type 1 diabetes manage their diabetes better. The purpose of the study is to evaluate the use of a state-of-the-art internet psycho-educational program in clinical practice. If our approach to dissemination via prescriptions by diabetes care providers is effective, teens will be able to access the program at their leisure. Preliminary studies have shown that the program results in better metabolic control and quality of life.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

This project will make an effective, internet-based program available to teens transitioning to adolescence and will result in better outcomes during the teen years.

Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?

As a pediatric nurse practitioner and behavioral scientist, I have devoted my clinical and research career to helping teens manage diabetes more effectively. This award will help move the translation of the approach we developed, TeenCope™, into practice so it can reach more youth.

In what direction do you see the future of diabetes research going?

The future of diabetes research is bright. While I expect that new treatments will be on the horizon, I believe that we must invest equally in the prevention and care of people living with diabetes today. In the behavioral realm, increasing use of social media will be important to study.