Diabetes Personal Trainer Outcomes: Short-term and One-year Outcomes of a “Diabetes Personal Trainer” Intervention among Youth with Type I Diabetes

Tonja R. Nansel; Ronald J. Iannotti; Bruce G. Simons-Morton; Christopher Cox; Leslie P. Plotnick; Loretta M. Clark; Linda Zeitzoff

doi:10.2337/dc06-2621

Diabetes Personal Trainer Outcomes: Short-term and One-year Outcomes of a “Diabetes Personal Trainer” Intervention among Youth with Type I Diabetes

Tonja R. Nansel, Ph.D. (nanselt{at}mail.nih.gov)¹,
Ronald J. Iannotti, Ph.D.¹,
Bruce G. Simons-Morton, Ed.D¹,
Christopher Cox, Ph.D¹,
Leslie P. Plotnick, M.D.²,
Loretta M. Clark, RN, CDE² and
Linda Zeitzoff, CPNP, CDE³

¹Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, NIH, DHHS, Bethesda, MD
²Department of Pediatric Endocrinology, Johns Hopkins Medical Center, Baltimore, MD
³Mt. Washington Pediatric Hospital, Baltimore, MD

Abstract

Objective: To assess the social-cognitive, behavioral, and physiological outcomes of a self-management intervention for youth with type 1 diabetes.

Research Design & Methods: 81 youths with type 1 diabetes ages 11 to 16 were randomized to usual care versus a “diabetes personal trainer” intervention, consisting of 6 self-monitoring, goal setting, and problem solving sessions with trained non-professionals. Assessments were completed at baseline and multiple follow-up intervals. Hemoglobin A1c (HbA1c) data were obtained from medical records. ANCOVA adjusting for age and baseline values were conducted for each outcome.

Results: At both short-term and 1-year follow-up, there was a trend for an overall intervention effect on HbA1c (short-term F=3.71, p=.06; 1-year F=3.79, p=.06), and a significant intervention-by-age interaction, indicating a great effect among older than younger youths (short-term F=4.78, p=.03; 1-year F=4.53, p=.04). Subgroup analyses demonstrated no treatment-group difference among younger youth, but a significant difference among the older youth. No treatment-group differences in parent or youth report of adherence were observed.

Conclusions: The diabetes personal trainer intervention demonstrated significant effects on HbA1c among middle adolescents.