Home-based behavioral health intervention: Use of a telehealth model to address poor adherence to type-1 diabetes medical regimens

Youth with insulin-dependent diabetes mellitus face complex treatment regimens and often have difficulty adhering to treatment requirements. Many behavioral-health intervention strategies, such as psychoeducational groups, diabetes summer camps, individual therapy, and residential treatment have been utilized to address this issue. While some have been effective, many barriers exist that limit the number of youth who are able to utilize these treatments. Additionally, the effectiveness of these treatments does not typically generalize to the home environment. Telephone-based, intensive, behavioral-health interventions may address barriers to treatment access by providing lower cost treatment that is easier to access for youth who do not live near a knowledgeable behavioral-health specialist. Additionally, delivery via telephone enables the interventions to take place in the home. This, in combination with parental involvement in the treatment, may increase generalization of the positive treatment outcomes to the home environment. The purpose of this paper is to describe a controlled trial of a telehealth intervention for youth whose diabetes is poorly managed. Preliminary outcome data for the trial are promising. Representative cases from the trial are presented in case-study format.