A Multicenter Randomized Controlled Trial of Motivational Interviewing in Teenagers With Diabetes

  1. Sue J. Channon, D CLIN PSYCH1,
  2. Michelle V. Huws-Thomas, MSC2,
  3. Stephen Rollnick, PHD3,
  4. Kerenza Hood, PHD4,
  5. Rebecca L. Cannings-John, MSC3,
  6. Carol Rogers, RGN5 and
  7. John W. Gregory, MD5
  1. 1Department of Child Psychology, Cardiff and Vale NHS Trust, Wales, U.K
  2. 2School of Nursing and Midwifery studies, Cardiff University, Wales, U.K
  3. 3Department of General Practice, Cardiff University, Wales, U.K
  4. 4South East Wales Trial Unit, Cardiff University, Wales, U.K
  5. 5Department of Child Health, Cardiff University, Wales, U.K
  1. Address correspondence and reprint requests to S. Channon, Child Clinical Psychology Department, Children's Centre, St. David's Hospital, Canton, Cardiff CF11 9XB, U.K. E-mail: sue.channon{at}cardiffandvale.wales.nhs.uk

Abstract

OBJECTIVE—We sought to examine the efficacy of motivational interviewing with teenagers aged 14–17 years with type 1 diabetes.

RESEARCH DESIGN AND METHODS—In a randomized controlled trial analyzed by intention to treat, 66 teenagers with type 1 diabetes attending diabetes clinics in South Wales, U.K., were randomly assigned to the intervention group (38) and control group (28). Teenagers in the intervention group received motivational interviewing, and the control group received support visits. All participants received individual sessions over 12 months. The main outcome measures assessed at baseline, 6, 12, and 24 months were serum A1C and psychosocial self-report questionnaires including quality of life and well-being measures.

RESULTS—At 12 months, 60 patients had complete data. At the end of the intervention (12 months), the mean A1C in the motivational interviewing group was significantly lower than in the control group (P = 0.04), after adjusting for baseline values. At 24 months (when n = 47), this difference in A1C was maintained (P = 0.003). There were differences in psychosocial variables at 12 months, with the motivational interviewing group indicating more positive well-being, improved quality of life, and differences in their personal models of illness (all P < 0.01). Some of these differences were maintained at 24 months.

CONCLUSIONS—Motivational interviewing can be an effective method of facilitating behavioral changes in teenagers with type 1 diabetes with subsequent improvement in their glycemic control.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 10 March 2007. DOI: 10.2337/dc06-2260. Clinical trial reg. no. NCT00326573, clinicaltrials.gov.

    Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc06-2260.

    S.J.C. is currently affiliated with the Child Clinical Psychology Department, Children's Centre, St. David's Hospital, Wales, U.K.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted February 20, 2007.
    • Received November 7, 2006.
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  1. Published online before print March 10, 2007, doi: 10.2337/dc06-2260 Diabetes Care June 2007 vol. 30 no. 6 1390-1395
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