针对 1 型糖尿病学龄儿童家庭糖尿病困扰的创新型可扩展数字疗法的早期成果。

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-09-26 DOI:10.3390/children11101169
Susana R Patton, Jessica S Pierce, Nicole Kahhan, Matthew Benson, Mark A Clements, Larry A Fox
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引用次数: 0

摘要

目的本文报告了一项新的移动医疗干预措施的初步结果,该措施旨在减少1型糖尿病(T1D)学龄儿童家庭的糖尿病困扰(DD),名为 "糖尿病困扰补救措施"(R2D2):我们将 34 个家庭(儿童平均年龄 = 10 ± 1.4 岁;53% 为男性,85% 为白人,平均 HbA1c = 7.24 ± 0.71%)随机分配到三个实施组中的一个,三个实施组的区别仅在于 10 周内远程医疗访问的次数:零次访问 = 自我指导 (SG),三次访问 = 增强自我指导 (ESG),八次访问 = 视频访问 (VV)。所有家庭都可以在 10 周内全天候访问数字治疗资料。我们研究了 R2D2 的可行性和可接受性。我们使用 "糖尿病-儿童问题领域"(PPAIDC 和 PAIDC,分别指父母和儿童)来按时间和提供方式检查治疗效果。我们进行了敏感性分析,以确定对 R2D2 有反应的家庭的特征:结果:尽管远程医疗访问的出席率参差不齐,但家庭独立访问 R2D2 移动医疗内容是可行的。家长和儿童的满意度都很高。PPAIDC(p = 0.026)和PAIDC(p = 0.026)得分在前后有明显降低,但各实施部门之间没有差异。接受治疗与未接受治疗的儿童在年龄、性别、种族或治疗前 HbA1c 方面没有差异,但接受治疗的家庭在治疗前的 PPAID-C 得分更高(p = 0.01),且糖尿病持续时间更短(p = 0.08):初步结果支持 R2D2 的可接受性和治疗效果,与辅助虚拟访问的频率无关。对应答者进行特征描述可能有助于识别将来可能从 R2D2 中受益的家庭。
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Early Results of an Innovative Scalable Digital Treatment for Diabetes Distress in Families of School-Age Children with Type 1 Diabetes.

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, 'Remedy to Diabetes Distress' (R2D2).

Methods: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access to digital treatment materials for 10 weeks. We examined the feasibility and acceptability of R2D2. We used the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, parent and child, respectively) to examine treatment effects by time and delivery arm. We performed sensitivity analyses to characterize families who responded to R2D2.

Results: It was feasible for families to access R2D2 mHealth content independently, though attendance at telehealth visits was variable. Parents and children reported high satisfaction scores. There were significant pre-post reductions in PPAIDC (p = 0.026) and PAIDC (p = 0.026) scores but no differences by delivery arm. There were no differences in child age, sex, race, or pre-treatment HbA1c for responders versus non-responders, though families who responded reported higher PPAID-C scores pre-treatment (p = 0.01) and tended to report shorter diabetes duration (p = 0.08).

Conclusions: Initial results support the acceptability and treatment effects of R2D2 regardless of the frequency of adjunctive virtual visits. Characterizing responders may help to identify families who could benefit from R2D2 in the future.

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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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