A multicomponent motivational intervention to improve adherence among adolescents with poorly controlled type 1 diabetes: a pilot study

Abstract

Objective: To adapt and pilot test a multicomponent motivational intervention that includes family-based contingency management (CM) for adolescents with poorly controlled type 1 diabetes.

Methods: A total of 17 adolescents, age 12-17 years (M = 14.8, SD = 1.5), with type 1 diabetes (duration M = 6.2 years, SD = 4.5) and mean HbA1c of 11.6% (SD = 2.5%) were enrolled. Adolescents and their parents received 14 weeks of motivational interviewing, clinic-based CM, and parent-directed CM that targeted increased blood glucose monitoring (BGM).

Results: Adolescents significantly increased their BGM (p < .001) and showed significantly improved HbA1c levels (glycemic control) from pre-to posttreatment (p < .0001).

Conclusions: 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.

Keywords: cognitive behavior therapy; contingency management; motivational interviewing; type 1 diabetes.

Figure 1.

Mean number of blood glucose monitoring (BGM) times per day and mean number of days per week with ≥6 times per day across the 14 treatment weeks. Note: N = 15; one participant moved away unexpectedly in week 9 of treatment and did not have access to a computer. This participant’s 9 week data were used in calculating the means displayed for weeks 10–14.