A Multicomponent Motivational Intervention to Improve Adherence Among Adolescents With Poorly Controlled Type 1 Diabetes: A Pilot Study

Stanger, Catherine; Ryan, Stacy R.; Delhey, Leanna; Thrailkill, Kathryn M.; Li, Zhongze; Li, Zhigang; Budney, Alan J.

doi:10.1093/jpepsy/jst032

Cited by 74 publications

(68 citation statements)

References 39 publications

(51 reference statements)

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“…First, Stanger and colleagues [15] taught parents of teens with T1D to deliver daily incentives or punishers based on SMBG adherence, and parents received rewards for correctly implementing the contract. Teaching parents the skills to deliver incentives contingent on objective evidence of proper diabetes management (e.g., using a wireless meter) may result in longer-term maintenance of treatment effects, especially with younger participants.…”

Section: Original Researchmentioning

confidence: 99%

“…This procedure, known as Bcontingency management^(CM), has been used to treat substance abuse [8], increase asthma and HIV medication adherence [9][10][11], increase physical activity levels and facilitate weight loss [12,13], and improve diabetes self-management in children and adolescents [14][15][16]. Contingency management has also been shown to be more effective when combined with other psychosocial interventions, such as motivational interviewing (MI) [17].…”

Section: Introductionmentioning

confidence: 99%

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Internet-based incentives increase blood glucose testing with a non-adherent, diverse sample of teens with type 1 diabetes mellitus: a randomized controlled Trial

Raiff

Barrry

Ridenour

et al. 2016

Behav. Med. Pract. Policy Res.

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Non-adherence with self-monitoring blood glucose (SMBG) among teenagers with type 1 diabetes can be a problem. The purpose of this study was to investigate the feasibility, acceptability, and preliminary efficacy of using Internet-based incentives to improve adherence with SMBG in non-adherent teenagers. Participants were randomly assigned to contingent (CS; N = 23), where they had to meet web camera-verified SMBG goals to earn incentives, or non-contingent (NS) groups (N = 18), where they earned incentives independent of adherence. Brief motivational interviewing (MI) was given prior to the intervention. Attrition was 15 % in the CS group. Participants and parents endorsed the intervention on all intervention dimensions. Daily SMBG increased after one MI session, and further increased when incentives were added, but significantly more for so for older participants. SMBG declined slowly over time, but only returned to baseline levels for younger NS participants. Internetbased incentive interventions are feasible, acceptable, and show promise for improving adherence with SMBG.

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Section: Original Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Internet-based incentives increase blood glucose testing with a non-adherent, diverse sample of teens with type 1 diabetes mellitus: a randomized controlled Trial

Raiff

Barrry

Ridenour

et al. 2016

Behav. Med. Pract. Policy Res.

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“…15 Finally, combining contingency management with MI, a pilot study of 17 adolescents (mean age = 14.8 ± 1.5) found youths who received the treatment increased their SMBG frequency by 2.2 checks/ day at posttreatment. 17 Youths also increased the mean number of days per week with at least 6 SMBG checks from 1.35 to 5.40 days/week. Interestingly, although contingency management and MI were ultimately combined, the first 2 ½ weeks of treatment just involved MI and even without incentives, youths nearly doubled the number of SMBG checks performed per day from week 1 to week 2, suggesting some impact from MI only.…”

Section: Smbgmentioning

confidence: 93%

“…[10][11][12][13] However, there are also a few promising behavioral interventions which have specifically targeted blood glucose monitoring, particularly in patients with T1DM. [14][15][16][17][18][19] While many of these studies present only preliminary results, some of the strategies incorporated in these interventions may be immediately deployable in a clinic setting and should be considered for future intervention trials. The purpose of this review is to summarize the literature specific to glucose monitoring in patients with diabetes focusing specifically on current adherence rates, barriers to monitoring, and promising intervention strategies.…”

mentioning

confidence: 99%

Adherence to Glycemic Monitoring in Diabetes

Patton

2015

J Diabetes Sci Technol

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Glucose monitoring either by self-monitoring of blood glucose (SMBG) or continuous glucose monitoring (CGM) plays an important role in diabetes management and in reducing risk for diabetes-related complications. However, despite evidence supporting the role of glucose monitoring in better patient health outcomes, studies also reveal relatively poor adherence rates to SMBG and CGM use and numerous patient-reported barriers. Fortunately, some promising intervention strategies have been identified that promote at least short-term improvements in patients' adherence to SMBG. These include education, problem solving, contingency management, goal setting, cognitive behavioral therapy, and motivational interviewing. Specific to CGM, interventions to promote greater use among patients are currently under way, yet one pilot study provides data suggesting better maintenance of CGM use in patients showing greater readiness for behavior change. The purpose of this review is to summarize the literature specific to glucose monitoring in patients with diabetes focusing specifically on current adherence rates, barriers to monitoring, and promising intervention strategies that may be ready to deploy now in the clinic setting to promote greater patient adherence to glucose monitoring. Yet, to continue to help patients with diabetes adhere to glucose monitoring, future research is needed to identify the treatment strategies and the intervention schedules that most likely lead to long-term maintenance of optimal glycemic monitoring levels.

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“…Looking across these interventions studies, the results are mixed in terms of intervention design and effectiveness. In some studies, small but statistically significant positive effects are noted, especially for adolescents with poorer glycemic control (e.g., Katz, Volkening, Butler, Anderson, & Laffel, 2014;Stanger et al, 2013;Wysocki et al, 2006;Wysocki et al, 2007;Wysocki et al, 2008).…”

Section: Family-focused Interventionsmentioning

confidence: 99%

Psychoeducational interventions to improve adolescents’ medical management of diabetes: A comprehensive review

Bergmame¹,

Shaw²

2017

Health Psychology Report

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). The increase in technologically assisted psychoeducational interventions using text, apps, and interactive Internet-based programming results in a qualitative update of psychoeducational interventions and program evaluations. Also noted is an increase in the number of family-focused interventions that have been evaluated and published. The results of the current comprehensive literature review yield 42 evaluative studies of psychoeducational interventions for adolescents with type 1 diabetes with mixed outcomes. Despite the variety of interventions and research designs, only two of the 42 studies reported moderate effect sizes. All the others indicated no effects or small effects. Although not conclusive, the most promising approaches involve the use of motivational interviewing involving individual, family, and technological support. The ramifications for future research, potential value of psychoeducational interventions for adolescents, and implementation of technology for delivering psychoeducational interventions for adolescents with diabetes are described. Background Type 1 diabetes is one of the most common chronic illnesses affecting young people in North America (Babler & Strickland, 2015). The incidence of diabetes is growing in the general population, but this growth is especially apparent in low socioeconomic status and ethnic minority groups (Kassai et al., 2015). Being diagnosed with diabetes has a negative influence on academic, social, medical, and overall well-being. However, these negative outcomes are mitigated by effective medical and psychoeducational management (Murphy, Wadham, Hassler-Hurst, Rayman, & Skinner, 2012). Medical management of diabetes requires a multidisciplinary approach that includes medical treatment and adherence to supportive lifestyle management (Sajatovic et al., 2011;Shalev, & Geffken, 2015). Changing behaviour involves psychoeducational interventions that are implemented by physicians, nurses, educators, and parents for the benefit of adolescents. However, the effectiveness of these interventions for changing long-term behaviours is not clear.Adolescents with diabetes present a specific set of developmental challenges in care and management. There is an increased desire for independence, yet the daily living skills required for independence are developing (Markowitz, Garvey, & Laffel, 2015). For all adolescents, this is a challenging developmental period. Many experience a wide range of adjustment and mental health problems (Chilton & Pires-Yfantouda, 2015). Behavior patterns established during this process, including those related to the management of chronic medical issues such as diabetes, can have long-lasting positive or negative effects on future health and well-being. As a result, professionals have unique opportunities to influence adolescents. Parents, members of the community, medical professionals, and educators have the responsibility to promote adolescent development and adjustment as well as to intervene effectively when problems arise. For adolescent...

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A Multicomponent Motivational Intervention to Improve Adherence Among Adolescents With Poorly Controlled Type 1 Diabetes: A Pilot Study

Abstract: The magnitude of improvements in the frequency of BGM and glycemic control in adolescents with type 1 diabetes is encouraging and will be tested in a randomized controlled trial.

Cited by 74 publications

References 39 publications

Internet-based incentives increase blood glucose testing with a non-adherent, diverse sample of teens with type 1 diabetes mellitus: a randomized controlled Trial

Internet-based incentives increase blood glucose testing with a non-adherent, diverse sample of teens with type 1 diabetes mellitus: a randomized controlled Trial

Adherence to Glycemic Monitoring in Diabetes

Psychoeducational interventions to improve adolescents’ medical management of diabetes: A comprehensive review

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