Shared Medical Appointments to Improve Outcomes in Adolescents With Type 1 Diabetes
Condition: Type 1 Diabetes
MeSH terms: Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      Adolescents and emerging adults with type 1 diabetes (T1D) experience significant struggles
      with their diabetes management resulting in worsening diabetes health and increased
      complications. This population's declining well-being occurs during a time when they should
      be at their healthiest and enjoying multiple exciting life transitions. Their worsening
      diabetes management is complicated by the fact they are also learning how to become more
      independent from their family in preparation for eventually leaving home. Furthermore, the
      number of people under 20 years of age diagnosed with T1D has increased dramatically over the
      past 10 years giving rise to increased concern about providing care to this population.

      The Team Clinic Intervention is an innovative clinical care approach to address the medical
      and developmental needs of adolescents with T1D and their families. A group medical
      appointment format will be used for routine diabetes clinic visits in middle school and high
      school adolescents with T1D. Parents of these patients will be participating in their own
      group during these clinic visits. The Team Clinic model incorporates developmentally tailored
      peer support and novel learning tools, (e.g. games, physical activity, and/or interaction
      through Internet resources, e.g. blogs, forums) into the shared medical appointment design.

      The goal of Team Clinic Intervention is to improve medical and psychological outcomes in
      adolescents with T1D and their parents. The study will investigate, in a randomized
      controlled trial, the efficacy of a novel clinical care model that addresses the unique
      developmental strengths and weaknesses of the T1D adolescent population. The Team Clinic
      format streamlines clinical care delivery to this often-challenging patient population
      without placing additional burden on youth, families, or clinics because the intervention
      will be completed during routine diabetes care visits. Moreover, the Team Clinic approach
      maximizes the benefits of peer support by delivering care in a group format to address the
      sense of isolation that teens and families coping with chronic illness often feel.

      If successful, the Team Clinic Intervention will not only positively impact adolescents with
      T1D and their families, but it could be used as a model of care for other adolescents with
      chronic medical conditions struggling to remain involved and invested in their medical care.
      Team Clinics may be one approach to successfully engaging adolescents in their diabetes care
      prior to their transition away from home, which will help them remain invested and active in
      their medical care through adolescence and young adulthood.
    


Intervention name(s): Team Clinic
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research