Psychosocial Functioning in Young Adults With Type 1 Diabetes
Condition: Type 1 Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Observational

Summary: 
      Background: The often studied psychosocial correlates that relate to health outcomes in
      adolescents with Type 1 Diabetes (T1D) are factors such as self-efficacy, depression,
      distress, quality of life, and adherence. These psychosocial factors are not well-studied
      within a young adult (YA) population and the parents of YAs during the transition planning
      phase. Impact: This study aids program development for pre-transfer educational interventions
      to ensure more successful post-transfer health outcomes from both a patient and parent
      perspective. Methods: This longitudinal study is designed to characterize the psychosocial
      factors relevant for a population of YA with T1D. Data analyses of these psychosocial and
      transition readiness variables allow for understanding of prospective health outcomes for
      young adults with T1D during the transition process. Implications/Future Directions: From a
      clinical perspective, the outcomes of this feasibility study will be two-fold: (1) establish
      which of the clinical measures used in the study are related to meaningful health outcomes in
      this young adult population in order to determine future standardized assessments in the
      Diabetes Center and (2) determine which psychosocial constructs are relevant to health
      outcomes to then more fully develop the Diabetes Center's transition program interventions to
      improve functioning clinic-wide (e.g., group day sessions). Finally, it would be attractive
      to various National Institutes of Diabetes and Digestive and Kidney Disorder (NIDDK) grant
      mechanisms to identify the relevant psychosocial measures that assess the psychosocial
      functioning of YA with diabetes after they transfer to adult care.
    

Detailed description: 
      The purpose of this study is to assess how psychosocial functioning and transition readiness
      (health knowledge and self-reported health-related skills) of young adults (aged 18-24) with
      Type 1 Diabetes (T1D) and their parents impact health outcomes before they transition to
      adult diabetes care. Transition of health care from pediatric to adult care systems is a
      complex process and is often a challenge for young adults. These transition barriers lead to
      gaps in healthcare, worsening of glycemic control, and increased hospitalizations/emergency
      room utilization. Initial program development efforts to prepare young adults for transition
      were developed at Cincinnati Children's Hospital Medical Center (CCHMC) based on best
      practice recommendations in the literature. The psychosocial correlates of health outcomes in
      this population are not well studied, though. Nor is it known whether these diabetes
      education interventions impact transition to adult care over time. The investigators will
      study how psychosocial factors (e.g., self-efficacy, depression, distress, quality of life,
      adherence, and risky behaviors) impact health outcomes (e.g., glycemic control) over a one
      year period, within the context of the current diabetes education transition program at
      Cincinnati Children's Hospital Medical Center (CCHMC) for young adults with T1D and their
      parents.
    

Intervention name(s): Psychosocial Survey Questionnaires
Intervention type(s): Other
Intervention description(s): Young adults with Type 1 Diabetes Mellitus will be invited to participate in a observational study in which they complete psychosocial measures immediately after completing a readiness transition survey and then again 1 year later.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        All YA (ages 18-24) who are seen in the CCHMC Diabetes Clinic and have recently (< 4
        months) completed the READdY assessment tool as part of their standard clinical care is
        eligible for the study. In addition, the YA will need to be planning to stay at CCHMC
        (i.e., not imminently being transferring their diabetes care to an adult provider) for the
        next 12 months.
      
Keywords: Young Adults; Psychosocial Functioning