Adolescent Emotional Control Moderates Benefits of a Multicomponent Intervention to Improve Type 1 Diabetes Adherence: A Pilot Randomized Controlled Trial

被引:7
作者
Lansing, Amy Hughes [1 ]
Stoianova, Maria [2 ]
Stanger, Catherine [2 ]
机构
[1] Univ Nevada, Dept Psychol, 1664 N Virginia St,MS 298, Reno, NV 89557 USA
[2] Geisel Sch Med, Ctr Technol & Behav Hlth, Dartmouth, NS, Canada
关键词
adherence; adolescence; emotion regulation; intervention; type; 1; diabetes; GLYCEMIC CONTROL; SELF-REGULATION; CONTINGENCY MANAGEMENT; FINANCIAL INCENTIVES; CHILDREN; BEHAVIOR; IMPACT; YOUTH;
D O I
10.1093/jpepsy/jsy071
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Objective We previously tested via randomized controlled trial a novel intervention for adolescents with type 1 diabetes and above-target glycemic control that combined web-delivered incentives for self-monitoring of blood glucose (SMBG) and brief web counseling with working memory training and parental contingency contracting training. Results showed improved SMBG and decreased glycosylated hemoglobin (HbA1c) at 6- and 12-month follow-ups. However, it has not been elucidated if improvements in SMBG mediated the immediate benefits of this treatment on HbA1c nor if this intensive intervention uniquely benefited a subgroup of adolescents with higher problems in emotional control. Methods Adolescents with type 1 diabetes and above-target glycemic control (n=61) were randomized to receive the 6-month intervention (n=30) or usual care (n=31). Adolescents completed the Behavior Rating Inventory of Executive Function-Self-Report, problems with emotional control subscale at baseline, and provided meter downloads to assess frequency of SMBG and completed an HbA1c blood draw at baseline and 6 months later. Results At 6-month follow-up, improvements in SMBG mediated the effects of receiving the treatment on having lower average HbA1c. Further, problems in emotional control moderated the benefits of the intervention on improvements in SMBG and in turn HbA1c. Only adolescents with above average problems in emotional control evidenced improvements in SMBG in response to treatment, which then explained lower HbA1c levels at 6-month follow-up. Conclusions This multicomponent, web-delivered intervention provided unique benefits for improving SMBG and lowering HbA1c in teens with higher problems in emotional control.
引用
收藏
页码:126 / 136
页数:11
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