Strengths-Based Multi-Level Behavioral Intervention to Promote Resilience and Self-Management in Youth with Type 1 Diabetes

Baylor College Of Medicine, Houston TX

Investigators

Abstract

PROJECT ABSTRACT Type 1 diabetes (T1D) management is challenging during early adolescence, a period often marked by increasing expectations for independent self-management and poorer glycemic and quality of life outcomes. The parent R01 is testing a multi-pronged intervention that uses strengths-based approaches to help youth achieve “resilient” diabetes outcomes, including high engagement in T1D self-management behaviors, HbA1c levels within the target range, and good quality of life. In this 6-month intervention: (1) parents use an app to recognize and reinforce their children’s positive T1D-related behaviors, (2) youth use an app to have positive interactions with parents and watch videos made by older adolescents with T1D about living well with T1D, (3) families have weekly 5-minute meetings about a family diabetes goal related to self-management, and (4) diabetes care providers lead a discussion with youth and parents about what youth are doing well for T1D during a routine care appointment. Primary outcomes are HbA1c, % glucose time in range, engagement in T1D self-management behaviors, and health-related quality of life. We are enrolling 250 racially/ethnically, socioeconomically, and linguistically diverse youth in Houston, TX and Washington, DC, who are randomly assigned to the intervention or enhanced usual care. Given known disparities among Latino people with T1D and historical exclusion of Spanish speaking individuals in T1D research, the parent R01 includes active recruitment of people who solely or primarily speak Spanish. However, recruitment and retention of Spanish speaking families requires additional strategies and time, and guidance is needed to ensure our recruitment, engagement, and retention approaches lead to adequate representation in this trial. Thus, this supplement aims to convene a community advisory board (CAB) who will review and provide experience-based recommendations to improve the current procedures for recruiting Spanish speaking families into the trial, engaging them in data collection and intervention activities, and retaining them in the trial throughout the study period. CAB members will review participation rates of Spanish speaking participants in the trial, provide suggestions to address challenges that arise, and partner with the research team to collect and interpret data from Spanish speaking trial participants about their experiences in the study. CAB activities will be conducted with guidance from the addition of a Co-Investigator with expertise in Community Engagement Research in pediatric health populations. Through the supplement, we will dedicate additional staff time and effort to focused enrollment and engagement with Spanish speaking families. The ultimate goal of this research is to ensure high representation of Spanish speaking families of youth with T1D in our behavioral research program testing a strengths-based intervention designed to promote optimal health behaviors, psychosocial well-being, and T1D health outcomes during early adolescence. Results will inform future interventions to maximize resilient outcomes for youth with T1D, including those from groups that have been systematically excluded from research.