Home Intervention and Social Precariousness in Childhood Diabetes
Condition: Diabetes Mellitus, Type 1
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      A pilot study of children whose families are in a precarious situation, who will benefit from
      a targeted at-home intervention by a pediatric nurse. Visits will be organized during the
      first, fourth and sixth months after the discovery of diabetes. The HbA1C measured 12 months
      after the diabetes diagnosis will be compared to the HbA1C obtained in an historical cohort
      that did not receive at-home therapeutic education.
    

Detailed description: 
      The EPICES score is an individual indicator of precariousness associated with indicators of
      access to health care and indicators of health. For this score, 30 is considered as the
      precariousness threshold. It is collected during the follow-up of our cohort of diabetic
      children and the data is obtained from the parent accompanying the child.

      In 2016, we found in this cohort that a context of precariousness was associated with a very
      poor result of glycated hemoglobin (HbA1C) (Lamaraud J et al., 2017). The imbalance of
      diabetes was detectable as early as one year after diagnosis and persisted despite additional
      educational interventions. Therapeutic education allows families in precarious situations to
      acquire, during the initial hospitalization, knowledge that meets the security objectives and
      is adapted to the care of their child. However, we have noticed that it can be difficult for
      some families to apply this knowledge when they are back in their home.

      Thus, we are planning to set up a coordinated intervention by a pediatric nurse at the
      child's home to support the parents in the implementation of the theoretical knowledge
      acquired at the hospital.

      Three home visits will be set up by a nurse during the first six months of the discovery of
      diabetes in the child. These visits will be organized during the first, fourth and sixth
      months after the discovery of diabetes and last about 2 hours each time. An additional visit
      may be set up according to the needs of families. The HbA1C measured 12 months after the
      diabetes diagnosis will be compared to the HbA1C obtained in an historical cohort that did
      not receive at-home therapeutic education.
    

Intervention name(s): Intervention by a pediatric nurse at the child's home
Intervention type(s): Behavioral
Intervention description(s): The intervention will consist of a coordinated intervention by a pediatric nurse at the child's home to support the parents in the implementation of the theoretical knowledge acquired at the hospital.
Three home visits will be set up by a nurse during the first six months of the discovery of diabetes in the child. These visits will be organized during the first, fourth and sixth months after the discovery of diabetes and last about 2 hours each time. An additional visit may be set up according to the needs of families.
Other intervention name(s): strategy under study ( for prospective group)
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Pediatric type-1 diabetes; Therapeutic education; Social precariousness