Check It! 2.0: Positive Psychology Intervention for Adolescents With Type 1 Diabetes
Condition: Type1diabetes
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      The treatment regimen for type 1 diabetes is complex and demanding, and many adolescents have
      problems with adherence. The proposed study will pilot test a positive psychology
      intervention for adolescents with type 1 diabetes aimed at improving adherence to treatment
      based on feedback from the first iteration of the intervention. The potential benefits
      include helping adolescents achieve better glycemic control, thereby reducing the health
      risks and complications associated with diabetes.
    

Detailed description: 
      The proposed study has the potential to improve adherence to the diabetes regimen in
      adolescents with type 1 diabetes without compromising their quality of life. The potential
      benefits include helping adolescents achieve better glycemic control, thereby reducing the
      health risks and complications associated with diabetes.

      The investigators will use a positive psychology framework, which emphasizes positive
      emotions and strengths rather than problems, to promote adherence.

      Positive affect, defined as feelings that reflect pleasurable engagement with the environment
      (e.g., happy, cheerful,proud), have been linked with favorable health outcomes and increased
      adherence to medical regimens. Further, positive affect has been shown to increase people's
      ability to use complex coping strategies. Randomized controlled trials of positive psychology
      interventions have been shown to successfully increase adults' adherence to medication and
      physical activity recommendations. However, no studies have examined the effects of positive
      psychology interventions on adherence behaviors in pediatric populations. Our ongoing work
      suggests that positive affect in adolescents with type 1 diabetes is related to greater use
      of adaptive coping strategies, lower levels of family conflict, and fewer depressive
      symptoms, and demonstrates that a positive psychology intervention has the potential to
      induce positive affect in adolescents. The investigators propose to pilot test a positive
      psychology intervention for adolescents with type 1 diabetes. This low-cost, innovative
      intervention is designed to induce positive affect in adolescents (age 13-17) through
      tailored exercises in gratitude and self-affirmation. The investigators will also promote
      positive parental involvement by asking caregivers to provide positive affirmation statements
      to adolescents. Finally, the investigators will explore the use of technology by delivering
      the intervention to adolescents and sending reminders to caregivers via text message using
      the Twilio/REDCap system.

      Blood glucose monitoring is one of the best indicators of adherence to the recommended
      treatment regimen for type 1 diabetes, and frequency of blood glucose monitoring is strongly
      related to glycemic control. Further, frequency of blood glucose monitoring has been shown to
      decrease with age in adolescents, and parental reminders to check blood glucose are often a
      source of conflict between adolescents and their parents. Therefore, blood glucose monitoring
      represents a specific behavior that may be the best target for adherence interventions in
      adolescents with type 1 diabetes.

      Thus, the specific aims are as follows:

      Aim 1: Adapt a positive psychology intervention for adolescents (age 13-17) with type 1
      diabetes designed to increase the frequency of blood glucose monitoring. Aim 2: Evaluate the
      feasibility, acceptability, and preliminary efficacy of a positive psychology intervention
      for adolescents with type 1 diabetes and their caregivers delivered by text message with the
      Twilio/REDCap system. The primary outcome is glycemic control, and secondary outcomes include
      positive affect, coping, adherence (i.e., frequency of blood glucose monitoring), family
      conflict, and quality of life.
    

Intervention name(s): Positive Psychology Intervention; Education
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Health Behavior Contract - Baseline visit Education Packet - Baseline visit Positive psychology training for teen and parents - baseline visit Parent praise reminder (text message) - one time per week (over 8 week intervention period) Teen gratitude message (text message) - every Monday (over 8 week intervention period) Teen positive value message (text message) - every Wednesday (over 8 week intervention period) Teen mood booster (text message) - every Thursday and Saturday and alternative Sundays (over 8 week intervention period) Small gift ($5 gift card code sent every 2 weeks for 8 weeks); Health Behavior Contract - Baseline visit Education Packet - Baseline visit
Other intervention name(s): Check It 2.0
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment