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Randomized Controlled Trial
. 2016 Jun 28;10(4):816-23.
doi: 10.1177/1932296816642577. Print 2016 Jul.

Videoconferencing for Teens With Diabetes: Family Matters

Danny C Duke  1 , David V Wagner  2 , Jenae Ulrich  3 , Kurt A Freeman  2 , Michael A Harris  3
Affiliations
Randomized Controlled Trial

Videoconferencing for Teens With Diabetes: Family Matters

Danny C Duke et al. J Diabetes Sci Technol. .

Abstract

Background: Adolescence is a developmental period associated with increased difficulty managing diabetes. During adolescence family functioning, including miscarried helping, family conflict, and acceptance of illness, is an important predictor of adherence to treatment recommendations. Multiple barriers exist to receiving behavioral health interventions to address suboptimal adherence. We hypothesized that behavioral family systems therapy-diabetes (BFST-D) delivered via telehealth would yield changes in family functioning that were not significantly different than changes in clinic-based treatment. Furthermore, that BFST-D would significantly improve overall family functioning.

Methods: Ninety adolescent participants and their parents were randomized to receive BFST-D via telehealth or traditional (Clinic) treatment conditions. Repeated measures ANOVAs were used to assess changes in mean scores across pre, post, and follow-up assessments. Mediation analyses were conducted using methods outlined by Sobel and were confirmed by bootstrapping.

Results: Changes in miscarried helping, family conflict and adjustment to illness were not significantly different across groups. Overall, clinically significant improvements were identified in youth- and parent-reported miscarried helping, family conflict, and acceptance of illness. Reductions in family conflict mediated the relationship between changes in miscarried helping and acceptance of illness. In addition, improvements in family functioning were associated with changes in adherence and glycemic control.

Conclusions: Results provide strong support for BFST-D (and similar interventions) delivered via telehealth as yielding outcomes no different than clinic-based treatment. In addition, further support was provided for the effectiveness of BFST-D.

Trial registration: ClinicalTrials.gov NCT02274103.

Keywords: adolescence; family factors; randomized clinical trial; teleconferencing; telehealth; type 1 diabetes.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Consolidated Standards of Reporting Trials Statement of Youth Recruitment.
Figure 2.
Figure 2.
Miscarried helping (HHI) across Pre, Post, and Follow-up assessments.
Figure 3.
Figure 3.
Family conflict (CBQ) across Pre, Post, and Follow-up assessments.
Figure 4.
Figure 4.
Acceptance of illness (AIS) across Pre, Post, and Follow-up assessments.
Figure 5.
Figure 5.
Family conflict mediating miscarried helping and adjustment to illness.
See this image and copyright information in PMC

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