An Internet-Based Program to Improve Self-Management in Adolescents with Type 1 Diabetes
- Shelagh A. Mulvaney, PhD (shelagh.mulvaney{at}vanderbilt.edu)1,2,
- Russell L. Rothman, MD, MPP3,
- Kenneth A. Wallston, PhD1,
- Cindy Lybarger, CDE, APRN1,2 and
- Mary S. Dietrich, PhD1,4
- 1 School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA
- 2 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- 3 Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA
- 4 Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
Abstract
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.
Footnotes
-
- Received October 9, 2009.
- Accepted December 13, 2009.
- Copyright © American Diabetes Association
