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Original Research

Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost

  1. Andrea F. Rodgers Fischl, PHD, MPH, CRNP1,
  2. William H. Herman, MD, MPH2,
  3. Susan M. Sereika, PHD1,
  4. Margaret Hannan, PHD, MSN, CPNP1,
  5. Dorothy Becker, MBBCH3,
  6. M. Joan Mansfield, MD4,
  7. Linda L. Freytag, RN3,
  8. Kerry Milaszewski, BSN, RN, CDE4,
  9. Amanda N. Botscheller, SN1 and
  10. Denise Charron-Prochownik, PHD, CPNP, FAAN1
  1. 1University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania;
  2. 2University of Michigan Schools of Medicine and Public Health, Ann Arbor, Michigan;
  3. 3Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;
  4. 4Joslin Diabetes Center, Boston, Massachusetts.
  1. Corresponding author: Denise Charron-Prochownik, dcpro{at}pitt.edu.
Diabetes Care 2010 Apr; 33(4): 701-705. https://doi.org/10.2337/dc09-1821
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Article Figures & Tables

Tables

  • Table 1

    Group response profiles for outcome variables at baseline, immediately after intervention, and 9-month follow-up post-test values

    Intervention group (n = 42)Control group (n = 45)FP
    Mean ± SERangeMean ± SERange
    Diabetes and pregnancy knowledge*
        Group32.34<0.001
        Time37.44<0.001
        Group-by-time32.3<0.0001
        Baseline52.1 ± 3.645–59.346.7 ± 3.539.7–53.7
        Immediately after intervention82.2 ± 3.176–88.448.3 ± 3.142.3–54.4
        9-Month follow-up81.3 ± 3.574.3–88.353.5 ± 3.346.9–60
    Benefits†
        Group9.700.0025
        Time14.02<0.0001
        Group-by-time11.2<0.0001
        Baseline16.5 ± 0.515.5–17.616 ± 0.515–17.1
        Immediately after intervention19.3 ± 0.418.5–20.316.2 ± 0.415.5–17
        9-Month follow-up18.3 ± 0.517.4–19.316.7 ± 0.515.8–17.6
    Intention to initiate discussion‡
        Group1.060.31
        Time15.54<0.0001
        Baseline8.71 ± 0.47.6–9.88.87 ± 0.697.75–9.97
        Immediately after intervention11.11 ± 0.59.9–12.310.1 ± 0.339.0–11.3
        9-Month follow-up11.2 ± 0.610.1–12.69.77 ± 0.468.8–11.2
        Group-by-time1.560.21
    Initiating discussion§
        Group1.900.17
        Time14.60.0003
        Baseline0.7 ± 0.090.4–0.90.6 ± 0.090.3–0.9
        9-Month follow-up1.4 ± 0.151.0–1.91.0 ± 0.150.5–1.4
        Group-by-time1.830.18
    • ↵*Knowledge of diabetes and pregnancy, a summation of 12 dichotomous items (correct = 1, incorrect = 0, % correct).

    • ↵†Perceived benefits of seeking and using family planning, a summation of 5 Likert-type items (possible range 5–25).

    • ↵‡Intention to initiate discussion with health care provider, a summation of 2 Likert-type items (possible range 2–14).

    • ↵§Actual initiation of discussion with health care provider, a summation of 4 dichotomous items (possible range 0–4), showing group change from baseline and at 9 months.

  • Table 2

    READY-Girls: resource use (minutes) by treatment group

    Intervention group (n = 42)Comparison group (n = 45)
    % of sampleNurseParticipantDoctor% of sampleNurseParticipantDoctor
    Session 1 time
        Setup1003.31 ± 2.47NANANANANANA
    2.00 (4.00)
        Training1003.06 ± 2.373.06 ± 2.37NANANANANA
    2.00 (4.00)2.00 (4.00)
        CD viewing100NA36.34 ± 6.20NANANANANA
    35.00 (8.00)
        Clinic‡100NA50.81 ± 18.550.81 ± 18.5100NA43.33 ± 31.543.33 ± 31.54
    55.0 (15.00)55.0 (15.00)30.0 (45.00)30.00 (45.00)
    Session 2 time
        Setup902.77 ± 1.91NANANANANANA
    2.00 (4.00)
        Training901.67 ± 1.461.67 ± 1.46NANANANANA
    1.00 (0.00)1.00 (0.00)
        CD viewing9025.38 ± 7.38NANANANANA
    25.0 (10.00)
        Counseling6.42 ± 5.116.42 ± 5.11NANANANANA
    5.00 (9.00)5.00 (9.00)
        Clinic‡9040.1 ± 10.4440.1 ± 10.4496NA57.1 ± 30.2657.06 ± 30.26
    43.0 (16.00)43.0 (16.00)60.0 (45.00)60.00 (45.00)
    Session 3 time
        Book review76NA20.37 ± 4.00NANANANA
    20.00 (5.00)
        Counseling764.38 ± 3.644.38 ± 3.64NANANANANA
    5.00 (7.00)5.00 (7.00)
        Clinic‡76NA47.5 ± 42.0747.5 ± 42.0779.5 ± 46.0179.5 ± 46.01
    30.0 (45.00)30.0 (45.00)60.0 (63.00)60.00 (63.00)
        Total sum of means
    UnweightedNA21.61236.10138.48NANA179.85179.85
    Weighted§NA19.47211.39123.06NANA170.42170.42
    • Data are means ± SD and median (interquartile range) unless otherwise indicated.

    • ↵‡Clinic time = face-to-face with health care provider, not intervention time.

    • ↵§Means weighted by participation weights (proportion of group that participated) before computing the weighted sum of means.

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Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost
Andrea F. Rodgers Fischl, William H. Herman, Susan M. Sereika, Margaret Hannan, Dorothy Becker, M. Joan Mansfield, Linda L. Freytag, Kerry Milaszewski, Amanda N. Botscheller, Denise Charron-Prochownik
Diabetes Care Apr 2010, 33 (4) 701-705; DOI: 10.2337/dc09-1821

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Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost
Andrea F. Rodgers Fischl, William H. Herman, Susan M. Sereika, Margaret Hannan, Dorothy Becker, M. Joan Mansfield, Linda L. Freytag, Kerry Milaszewski, Amanda N. Botscheller, Denise Charron-Prochownik
Diabetes Care Apr 2010, 33 (4) 701-705; DOI: 10.2337/dc09-1821
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