A multisite trial of a clinic-integrated intervention for promoting family management of pediatric type 1 diabetes: feasibility and design

Pediatr Diabetes. 2009 Apr;10(2):105-15. doi: 10.1111/j.1399-5448.2008.00448.x. Epub 2008 Aug 20.

Abstract

The feasibility of a family-based clinic-integrated behavioral intervention to improve family management of type 1 diabetes was evaluated. In each of four clinical sites, 30-32 families (a total of 122) were randomized to intervention or usual care comparison groups. The WE*CAN intervention, based on family problem-solving methods, was delivered during three routine clinic visits by trained 'Health Advisors'. Of eligible families across the four sites, 83% agreed to participate, of whom 96% completed the baseline, mid-term, and postintervention assessments. Families participated in an average of 2.85 intervention sessions over an 8-month period. The intervention was integrated into the clinic setting without impairing clinic flow and was implemented with fidelity and consistency across sites by trained non-professionals. The findings provide evidence of the feasibility of conducting a multisite trial to evaluate the effects of a clinic-integrated problem-solving intervention to improve family management. Many lessons were learned that provide guidance for recruitment, measurement, and intervention for the larger clinical trial.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Blood Glucose Self-Monitoring
  • Child
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / therapy*
  • Diet
  • Disease Management
  • Exercise
  • Feasibility Studies
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Insulin / administration & dosage
  • Interviews as Topic
  • Outcome Assessment, Health Care*
  • Parent-Child Relations*
  • Patient Satisfaction
  • Patient Selection
  • Pilot Projects
  • Problem Solving
  • United States / epidemiology

Substances

  • Hypoglycemic Agents
  • Insulin