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

Abstract

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.

Use and perception of telemedicine in people with type 1 diabetes during the COVID‐19 pandemic—Results of a global survey

“…While discussions about remote telemedicine are rapidly increasing due to the pandemic, a number of studies have previously investigated the potential benefits of telemedicine in diabetes care. 6,9,10 In a systematic review of 29 studies in the field of paediatric diabetes care, 7 it was concluded that telemedicine has the potential to facilitate patient monitoring and can improve short-term glycaemic control in some contexts. It has also been suggested that virtual diabetes care may prove effective in aiding behavioural change, as well as providing social and psychological support.…”

Assessing the benefits and challenges of video consultations for the treatment of children with type 1 diabetes – A qualitative study among diabetes professionals

“…as being discussed face-to-face. Recent studies have shown that telemedicine in diabetes care might improve self-management, therapy engagement, and metabolic outcomes [1,3,4]. It is assumed that patients and diabetes teams have positive attitudes about video consultation if they have the means to set it up technically and carry it out.…”

Letramento em saúde de mães no gerenciamento de situações de urgência dos filhos com diabetes

“…Estudos futuros podem testar intervenções que visem melhorar o LS das mães sobre o manejo das situações de urgência. Experiências prévias no ensino de outros tópicos de suporte de vida mostram que o uso de aulas teórico-práticas e de simulação realística pode empoderar as mães para o cuidado da criança em urgências 23,24 .…”