High Risk Youth With Poorly-controlled Diabetes
Condition: Type 1 Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      This study aims to implement a group education curriculum integrated with social media
      participation to provide peer support and interactive education sessions with the goal of
      improving glycemic control in disadvantaged youth with poorly-controlled type 1 diabetes.
    

Detailed description: 
      It has been well established through The Diabetes Control and Complications Trial (DCCT) and
      its follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) studies that
      achieving lower hemoglobin A1c (HbA1c) levels are associated with the delay and prevention of
      long-term complications of T1DM (1, 2). Management of T1DM involves adherence to a complex,
      labor-intensive regimen of subcutaneous insulin treatment, close glucose monitoring, accurate
      calculation of carbohydrate intake, and adjustment of dosing and dietary regimen to account
      for physical activity.

      Recent technological advances including insulin pumps with auto-insulin-adjusting features
      along with continuous glucose monitoring systems have allowed for individuals with T1DM to
      achieve tighter diabetes control. However, despite these advances in glucose monitoring and
      insulin delivery systems, the majority of children and adolescents fail to optimize their
      diabetes control and are unable to achieve these targets.

      Several studies have shown that adolescents in poor diabetes control are more likely to come
      from a racial minority background, have lower annual household income, and be publicly
      insured. In addition, these patients are also more likely to have missed medical appointments
      and have less stable home environments. Thus, increased efforts and innovative programs are
      needed to overcome additional barriers faced by youth with T1DM from disadvantaged
      backgrounds with the goal of improving the delivery of diabetes care for our most vulnerable,
      at-risk youth population.

      The objective of this pilot and feasibility project is to implement a clinic-based group
      education program targeting teens with poorly controlled diabetes, focusing on peer group
      interaction and education combined with social media support to increase engagement and
      promote behavioral change to improve glycemic control.

      This study utilizes 1) group education sessions (6 total sessions over the course of 9
      months), 2) online social media group forums, 3) questionnaires to assess self-care habits in
      diabetes management and quality of life, and 4) surveys to assess this program.

      Patients will be included in closed, private Facebook, Snapchat, and Instagram groups where
      members can communicate with each other and where biweekly updates, reminders, and messages
      of encouragement relevant to the previous topic covered at group sessions can be sent to the
      group. Online group forums will be moderated by a staff member to ensure that message content
      is appropriate and to avoid misinformation or questionable patient-to-patient medical advice.
    

Intervention name(s): Group education sessions
Intervention type(s): Other
Intervention description(s): Peer support and interaction both in-person during group education sessions and online via social media platforms
Other intervention name(s): Social media peer support
Intervention model: Single Group Assignment
Intervention model description: The intervention being studied is a group education program
Masking: None (Open Label)
Primary purpose: Other
Keywords: social media; noncompliance; youth; group education