Evaluation of peer-group support and problem-solving training in the treatment of adolescents with type 1 diabetes

Abstract

Aim: The aim of this study was to describe the elements and results of peer-group support and problem-solving training in the treatment of adolescents with type 1 diabetes and their parents. The hypothesis was that the intervention would improve HbA 1c and enable the adolescents to take responsibility in managing their diabetes. Method: A total of 60 adolescents with type 1 diabetes, aged 13-18 years, and their parents, were invited to participate in this study. They were recruited from outpatient clinics in two centres in Norway, and 19 adolescents agreed to participate. Both adolescents and parents completed self-report questionnaires pre-treatment, during treatment, post-treatment and at one year follow up. In addition HbA 1c values were obtained five times from the adolescents' medical records over the same time period. Results:The results indicated that peer-group support and problem-solving training is a suitable intervention in the treatment of adolescents with type 1 diabetes. In terms of metabolic control there was a significant decrease in HbA 1c in girls (p=0.039). Conclusion:The intervention was peer-oriented and psycho-educative, and encouraged collaboration between the paediatric diabetes clinic and the psychiatric department in the treatment for adolescents with diabetes and their parents. This collaboration was of great importance for the quality of the study and added valuable knowledge and experience to the diabetes multidisciplinary team.Eur Diabetes Nursing 2007; 4(1): 28-33.

Problem solving interventions for diabetes self-management and control: A systematic review of the literature

“…Three (13%) studies [9,16,17] examined only females and 2 (8%) studies did not report gender [21,30], but the rest of the studies included both genders. Race/ethnicity of study participants was not reported in 3 (13%) studies [18,22,31]. One study examined Caucasians [32], 12 (50%) studies included multiple ethnicities (generally Caucasian, African American, and Latino)[7,11,12,14-16,19,21,23,25,26,30], 5 (21%) studies were African American only [8,9,20,27,28], 2 study samples were Latino[13,17], and 1 study sample was South Korean [24].…”

“…Of the seven studies of children and adolescents, five (71%) [7,11,21-23] were randomized controlled trials and the remaining two were quasi-experimental designs [31,32] (Table 2). In five (71%) of the intervention studies problem-solving was the main behavioral treatment approach, [7,11,21,22,31] and in two studies problem solving was combined with Behavioral Family Systems Therapy [23] or Cognitive Behavioral Therapy [23,32].…”

“…In five (71%) of the intervention studies problem-solving was the main behavioral treatment approach, [7,11,21,22,31] and in two studies problem solving was combined with Behavioral Family Systems Therapy [23] or Cognitive Behavioral Therapy [23,32]. Interventions were delivered in varying formats, including individual face-to-face [32], single family face-to-face [7,11,21,23], group face-to-face [31], multifamily face-to-face [23], internet-based [22], and telephone follow-ups after face-to-face sessions [7,11,21,32]. Three of the studies delivered the intervention during routine clinic visits [7,11,21].…”

“…Only two of the six studies (33%) reported significant improvement in HbA1c associated with the intervention. Loding et al, [31] found a significant decrease in HbA1c (from 9.4% to 8.4%) in girls, but not in boys, at the 12 month follow-up. Among adolescents who received BFST-D [23] problem-solving and poor problem resolution was significantly, positively correlated with HbA1c level at the six month follow-up assessment.…”

A systematic review of parent/peer-based group interventions for adolescents with type 1 diabetes: interventions based on theoretical/therapeutic frameworks

“…Two domains of outcome measures were extracted: diabetes functioning/medically performing/HbA1c and psychosocial functioning. Studies were excluded if they involved improving education alone, had no explicit theoretical background, 6,7,[44][45][46] were not a RCT, 15,[46][47][48][49][50] included children only 51,52 or adults 53 54 ) were checked in order to capture other relevant publications (see Appendix A for search terms at www.bjd-abcd.com).…”