An Internet-Based Program to Improve Self-Management in Adolescents with Type 1 Diabetes

  1. Shelagh A. Mulvaney, PhD (shelagh.mulvaney{at},2,
  2. Russell L. Rothman, MD, MPP3,
  3. Kenneth A. Wallston, PhD1,
  4. Cindy Lybarger, CDE, APRN1,2 and
  5. Mary S. Dietrich, PhD1,4
  1. 1 School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA
  2. 2 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
  3. 3 Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA
  4. 4 Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA


Objective: To report results from YourWay, an Internet-based self-management intervention for adolescents with type 1 diabetes.

Research Design and Methods: A total of 72 adolescents with type 1 diabetes, ages 13-17, were randomized to a usual-care-plus-Internet support or a usual-care group. The intervention was designed to enhance problem-solving barriers to self-management. A1C was obtained from medical records, and problem-solving and self-management were obtained via adolescent report.

Results: Group differences were not statistically significant using intent to treat analyses. Using as-treated analyses, adolescents in the treatment condition showed statistically significant improvement in self-management (d 0.64; P=.02) and important improvements in problem-solving (d 0.30; P=.23), and A1C (d −0.28; P=.27). Mean A1C for the intervention group remained constant (−0.01%) while the control group increased (0.33%).

Conclusion: This brief trial suggests that self-management support delivered through a secure website may improve self-management and offset typical decreases in adolescent glycemic control.


    • Received October 9, 2009.
    • Accepted December 13, 2009.

This Article

  1. Diabetes Care
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