Randomized trial of a diabetes self-management education and family teamwork intervention in adolescents with Type 1 diabetes

H.R Murphy, C Wadham, J Hassler-Hurst, G Rayman, Timothy Skinner

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aims: To evaluate theeffectiveness of a family-centred group education programme, in adolescentswith Type 1 diabetes.

     

    Methods: Three hundred and fiveadolescents with Type 1 diabetes; age 13.1 ± 1.9 years,diabetes duration 5.6 ± 3.3 years, BMI20.9 ± 3.7 kg/m2, HbA1c 78 ± 6 mmol/mol(9.3 ± 1.9%) were randomly allocated to the Families and AdolescentsCommunication and Teamwork Study (FACTS) diabetes education programme; (six90-min monthly sessions attended by parents and adolescents incorporatingskills training and family teamwork) or conventional clinical care. Primaryoutcome was HbA1c at 18 months (12 months post-intervention).Secondary outcomes were HbA1c at 9 months, psychosocial outcomes,adolescent quality of life, well-being, family responsibility and insulin doseadjustment behaviours at 12 months (6 months post-intervention) andepisodes of severe hypoglycaemia and diabetic ketoacidois during the12 months post-intervention. All analyses are intention to treat.

     

    Results: Session attendance was poorwith 48/158 families (30.4%) not attending any sessions and only 75/158 (47.5%)families attending ≥ 4 group education sessions. All biomedical andpsychosocial outcomes were comparable between groups. At 18 months therewas no significant difference in HbA1c in either group and nobetween-group differences over time: intervention group 75 mmol/mol (9.0%)to 78 mmol/mol (9.3%), control group 77 mmol/mol (9.2%) to80 mmol/mol (9.5%). Adolescents perceived no changes in parental input at12 months.

     

    Conclusion: Poor attendance of groupeducation sessions delivered in routine clinics was a major challenge. Morepersonalized educational approaches may be required to support and motivatefamilies who are struggling to integrate the demands of intensive insulinregimens into their daily lives.

    Original languageEnglish
    Pages (from-to)e249-e254
    Number of pages6
    JournalDiabetic Medicine
    Volume29
    Issue number8
    DOIs
    Publication statusPublished - 2012

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    Self Care
    Type 1 Diabetes Mellitus
    Education
    Intention to Treat Analysis
    Hypoglycemia
    Parents
    Quality of Life
    Insulin
    Control Groups

    Cite this

    Murphy, H.R ; Wadham, C ; Hassler-Hurst, J ; Rayman, G ; Skinner, Timothy. / Randomized trial of a diabetes self-management education and family teamwork intervention in adolescents with Type 1 diabetes. In: Diabetic Medicine. 2012 ; Vol. 29, No. 8. pp. e249-e254.
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    title = "Randomized trial of a diabetes self-management education and family teamwork intervention in adolescents with Type 1 diabetes",
    abstract = "Aims: To evaluate theeffectiveness of a family-centred group education programme, in adolescentswith Type 1 diabetes. Methods: Three hundred and fiveadolescents with Type 1 diabetes; age 13.1 ± 1.9 years,diabetes duration 5.6 ± 3.3 years, BMI20.9 ± 3.7 kg/m2, HbA1c 78 ± 6 mmol/mol(9.3 ± 1.9{\%}) were randomly allocated to the Families and AdolescentsCommunication and Teamwork Study (FACTS) diabetes education programme; (six90-min monthly sessions attended by parents and adolescents incorporatingskills training and family teamwork) or conventional clinical care. Primaryoutcome was HbA1c at 18 months (12 months post-intervention).Secondary outcomes were HbA1c at 9 months, psychosocial outcomes,adolescent quality of life, well-being, family responsibility and insulin doseadjustment behaviours at 12 months (6 months post-intervention) andepisodes of severe hypoglycaemia and diabetic ketoacidois during the12 months post-intervention. All analyses are intention to treat. Results: Session attendance was poorwith 48/158 families (30.4{\%}) not attending any sessions and only 75/158 (47.5{\%})families attending ≥ 4 group education sessions. All biomedical andpsychosocial outcomes were comparable between groups. At 18 months therewas no significant difference in HbA1c in either group and nobetween-group differences over time: intervention group 75 mmol/mol (9.0{\%})to 78 mmol/mol (9.3{\%}), control group 77 mmol/mol (9.2{\%}) to80 mmol/mol (9.5{\%}). Adolescents perceived no changes in parental input at12 months. Conclusion: Poor attendance of groupeducation sessions delivered in routine clinics was a major challenge. Morepersonalized educational approaches may be required to support and motivatefamilies who are struggling to integrate the demands of intensive insulinregimens into their daily lives.",
    author = "H.R Murphy and C Wadham and J Hassler-Hurst and G Rayman and Timothy Skinner",
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    Randomized trial of a diabetes self-management education and family teamwork intervention in adolescents with Type 1 diabetes. / Murphy, H.R; Wadham, C; Hassler-Hurst, J; Rayman, G; Skinner, Timothy.

    In: Diabetic Medicine, Vol. 29, No. 8, 2012, p. e249-e254.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

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    AU - Skinner, Timothy

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    N2 - Aims: To evaluate theeffectiveness of a family-centred group education programme, in adolescentswith Type 1 diabetes. Methods: Three hundred and fiveadolescents with Type 1 diabetes; age 13.1 ± 1.9 years,diabetes duration 5.6 ± 3.3 years, BMI20.9 ± 3.7 kg/m2, HbA1c 78 ± 6 mmol/mol(9.3 ± 1.9%) were randomly allocated to the Families and AdolescentsCommunication and Teamwork Study (FACTS) diabetes education programme; (six90-min monthly sessions attended by parents and adolescents incorporatingskills training and family teamwork) or conventional clinical care. Primaryoutcome was HbA1c at 18 months (12 months post-intervention).Secondary outcomes were HbA1c at 9 months, psychosocial outcomes,adolescent quality of life, well-being, family responsibility and insulin doseadjustment behaviours at 12 months (6 months post-intervention) andepisodes of severe hypoglycaemia and diabetic ketoacidois during the12 months post-intervention. All analyses are intention to treat. Results: Session attendance was poorwith 48/158 families (30.4%) not attending any sessions and only 75/158 (47.5%)families attending ≥ 4 group education sessions. All biomedical andpsychosocial outcomes were comparable between groups. At 18 months therewas no significant difference in HbA1c in either group and nobetween-group differences over time: intervention group 75 mmol/mol (9.0%)to 78 mmol/mol (9.3%), control group 77 mmol/mol (9.2%) to80 mmol/mol (9.5%). Adolescents perceived no changes in parental input at12 months. Conclusion: Poor attendance of groupeducation sessions delivered in routine clinics was a major challenge. Morepersonalized educational approaches may be required to support and motivatefamilies who are struggling to integrate the demands of intensive insulinregimens into their daily lives.

    AB - Aims: To evaluate theeffectiveness of a family-centred group education programme, in adolescentswith Type 1 diabetes. Methods: Three hundred and fiveadolescents with Type 1 diabetes; age 13.1 ± 1.9 years,diabetes duration 5.6 ± 3.3 years, BMI20.9 ± 3.7 kg/m2, HbA1c 78 ± 6 mmol/mol(9.3 ± 1.9%) were randomly allocated to the Families and AdolescentsCommunication and Teamwork Study (FACTS) diabetes education programme; (six90-min monthly sessions attended by parents and adolescents incorporatingskills training and family teamwork) or conventional clinical care. Primaryoutcome was HbA1c at 18 months (12 months post-intervention).Secondary outcomes were HbA1c at 9 months, psychosocial outcomes,adolescent quality of life, well-being, family responsibility and insulin doseadjustment behaviours at 12 months (6 months post-intervention) andepisodes of severe hypoglycaemia and diabetic ketoacidois during the12 months post-intervention. All analyses are intention to treat. Results: Session attendance was poorwith 48/158 families (30.4%) not attending any sessions and only 75/158 (47.5%)families attending ≥ 4 group education sessions. All biomedical andpsychosocial outcomes were comparable between groups. At 18 months therewas no significant difference in HbA1c in either group and nobetween-group differences over time: intervention group 75 mmol/mol (9.0%)to 78 mmol/mol (9.3%), control group 77 mmol/mol (9.2%) to80 mmol/mol (9.5%). Adolescents perceived no changes in parental input at12 months. Conclusion: Poor attendance of groupeducation sessions delivered in routine clinics was a major challenge. Morepersonalized educational approaches may be required to support and motivatefamilies who are struggling to integrate the demands of intensive insulinregimens into their daily lives.

    U2 - 10.1111/j.1464-5491.2012.03683.x

    DO - 10.1111/j.1464-5491.2012.03683.x

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    SP - e249-e254

    JO - Diabetic Medicine

    JF - Diabetic Medicine

    SN - 0742-3071

    IS - 8

    ER -