Team Clinic: Group Approach to Care of Early Adolescents With Type 1 Diabetes

McClain, Megan; Klingensmith, Georgeanna J.; Anderson, Barbara J.; Berget, Cari; Cain, Cindy; Shea, Jacqueline J.; Campbell, Kristen; Pyle, Laura; Raymond, Jennifer

doi:10.2337/ds17-0063

Cited by 9 publications

(10 citation statements)

References 15 publications

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“…The Team Clinic model incorporates developmentally-tailored peer support and novel learning tools (e.g., games, physical activity, and skills station) into the SMA design, as previously described. 28,29 Group sessions included six participants per session and were led by a rotation of facilitators, who were certified diabetes educators (nurses, dieticians, and social workers). The entire group session lasts 45-60 min.…”

Section: Clinical Processmentioning

confidence: 99%

“…Children's Depression Inventory 2 (CDI-2)40 The CDI-2 is a28-item, widely used screening tool for depressive symptoms in youth 7-17 years of age in both clinical and research settings. The CDI-2 assesses two scales (Emotional Problems and Functional Problems) and four subscales (Negative Mood/Physical Symptoms, Negative Self-Esteem, Ineffectiveness/ Anhedonia [loss of enjoyment], and Interpersonal Problems).…”

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confidence: 99%

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Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments

et al. 2021

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For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school‐aged youth. Youth with T1D, 11–13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed‐effects models. Eighty‐six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the 12‐month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p = 0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p = 0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. Participation in Team Clinic was associated with improved psychosocial outcomes in middle school‐aged participants with T1D.

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Section: Clinical Processmentioning

confidence: 99%

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confidence: 99%

Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments

et al. 2021

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“…Another SMA model for adolescents, "Team Clinic," successfully improved appointment attendance, exposed patients to more educational materials, and increased both satisfaction and efficiency of care delivery compared to traditional clinic visits. [55][56][57] Team Clinic demonstrated success as an intervention for middle school and high school students; however, attending Team Clinic was a challenge for YAs (unpublished data).…”

Section: Models Of Care For Yas With T1dmentioning

confidence: 99%

Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes

et al. 2019

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Purpose To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D). Methods YAs self-selected to participate in the CoYoT1 Clinic or serve as a usual care control. CoYoT1 Clinic visits consisted of an individual appointment with a provider and a group appointment with other YAs with T1D using home telemedicine. Psychosocial and behavioral functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy for Diabetes Scale, Self-Management of Type 1 Diabetes in Adolescence Scale, and Center for Epidemiologic Studies Depression Scale. Results Forty-two patients participated in the CoYoT1 Clinic and 39 patients served as controls. CoYoT1 participants reported lower levels of distress ( P = .03), increased diabetes self-efficacy ( P = .01), and improved ability to communicate with others about diabetes ( P = .04) over the study period compared to controls. YA males in the control group reported increases in depressive symptoms ( P = .03) during the study period, but CoYoT1 participants showed no changes. Conclusion Group home telemedicine for YAs with T1D positively affects diabetes distress, self-efficacy, and diabetes-specific communication. These positive findings have the potential to also affect the YAs’ long-term diabetes outcomes. Further investigation of the model is needed.

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“…Notably, telehealth has been shown to engage YAs with type 1 diabetes and improve their psychosocial outcomes (2,15), with recent studies demonstrating promise for diverse YAs. For example, a virtual intervention for YAs with type 1 diabetes, Colorado Young Adults with Type 1 Diabetes (CoYoT1) Clinic, was adapted from an in-person shared medical appointment (SMA) model for adolescents with type 1 diabetes and their families (48,49). CoYoT1 Clinic was developed as a virtual option for a predominately White YA population (18-25 years of age) with type 1 diabetes who were receiving care in a standalone diabetes center.…”

Section: Discussionmentioning

confidence: 99%

Telehealth for Young Adults With Diabetes: Addressing Social Determinants of Health

et al. 2021

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Type 1 diabetes is a challenging chronic condition and can lead to diabetes-related distress and disengagement. Historically disadvantaged, racially and ethnically diverse young adults (YAs) with type 1 diabetes experience higher blood glucose levels and encounter more barriers to care than their White counterparts. Current research shows that telehealth may provide a route for improving psychosocial issues and diabetes care among YAs.

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Team Clinic: Group Approach to Care of Early Adolescents With Type 1 Diabetes

Cited by 9 publications

References 15 publications

Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments

Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments

Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes

Telehealth for Young Adults With Diabetes: Addressing Social Determinants of Health

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