Strengths-Based Behavioral mHealth App for Parents of Adolescents With Type 1 Diabetes-Pilot Study
Condition: Diabetes Mellitus, Type 1
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      Type 1 diabetes (T1D) management is particularly challenging during adolescence as
      responsibility for management begins to shift from parents to youth, and positive family
      teamwork is critical to achieving optimal diabetes outcomes. Existing behavioral family
      interventions for T1D are beneficial but have limited potential for translation to clinical
      practice, and universal preventive approaches designed to explicitly promote existing T1D
      management strengths are needed. Ultimately, the goal of this line of research is to validate
      brief, convenient, and helpful tools that families of all adolescents with T1D can use to
      strengthen positive family teamwork and ultimately promote optimal diabetes health outcomes.
    

Detailed description: 
      Type 1 diabetes (T1D) is among the most common chronic conditions of childhood and its
      management is complex and relentless. Adolescents have increased risk for worsening glycemic
      control, putting them at risk for short- and long-term complications. As responsibility for
      daily T1D management tasks begins to shift from parents to youth, supportive
      parent-adolescent teamwork promotes optimal diabetes outcomes. However, adolescents'
      cognitive development, desire for autonomy, and changing family and social relationships can
      make adherence to treatment recommendations difficult and strain attempts at
      parent-adolescent teamwork. This study aims to develop and pilot test a mobile app-based
      behavioral intervention to facilitate positive, supportive parent-adolescent interactions
      around T1D management. The proposed study has two parts. First, adolescents with T1D (age
      12-17), their parents, and diabetes care providers will be invited to participate in
      designing a smartphone app that supports parents to recognize, keep track of, and reinforce
      their adolescents for specific positive T1D-related behaviors, or strengths. Example
      strengths include asking for help with complicated diabetes tasks, talking to friends about
      diabetes, and expressing confidence or optimism about T1D management. Intermittently
      throughout the day, the app will push parents a prompt to report which positive T1D behaviors
      their adolescent has engaged in. The app will generate weekly summary reports of each
      adolescent's most frequent strength behaviors, and parents will be reminded via the app to
      praise their adolescent for those patterns. Second, this intervention will be pilot tested
      with 82 families; parents will be randomized to an intervention or a control condition.
      Participants in the intervention condition will use the app for 3-4 months and provide
      feedback, and control participants will receive usual care and will not use the app. The main
      goal is to determine how often and in what ways families use the app, whether they like it,
      and to obtain suggestions for improvement. Trends for impact on important diabetes outcomes,
      such as quality of parent-adolescent relationships, T1D treatment adherence, and glycemic
      control will also be evaluated. Data - including questionnaires, adherence data from blood
      glucose meters, and glycemic control biomarkers from a blood draw - will be collected at
      baseline and again 3-4 months later. The results of this pilot study will help refine the
      intervention so that it can be evaluated in a fullscale randomized controlled trial.
      Ultimately, the goal of this research is to validate brief, convenient, and helpful tools
      that families of all adolescents with T1D can use to strengthen positive family teamwork and
      ultimately promote optimal diabetes health outcomes.
    

Intervention name(s): T1Doing Well
Intervention type(s): Behavioral
Intervention description(s): Strengths-based mobile health (mHealth) app for parents of adolescents with type 1 diabetes, which will prompt parents to recognize and reinforce their adolescents' diabetes-related strength behaviors
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Strengths-based; Mobile Health (mHealth); Adolescence; Resilience; Family