PT  - JOURNAL ARTICLE
AU  - Fischl, Andrea F. Rodgers
AU  - Herman, William H.
AU  - Sereika, Susan M.
AU  - Hannan, Margaret
AU  - Becker, Dorothy
AU  - Mansfield, M. Joan
AU  - Freytag, Linda L.
AU  - Milaszewski, Kerry
AU  - Botscheller, Amanda N.
AU  - Charron-Prochownik, Denise
TI  - Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost
AID  - 10.2337/dc09-1821
DP  - 2010 Apr 01
TA  - Diabetes Care
PG  - 701--705
VI  - 33
IP  - 4
4099  - http://care.diabetesjournals.org/content/33/4/701.short
4100  - http://care.diabetesjournals.org/content/33/4/701.full
SO  - Diabetes Care2010 Apr 01; 33
AB  - OBJECTIVE To evaluate the impact of a preconception counseling program tailored for teens with type 1 diabetes on cognitive, psychosocial, and behavioral outcomes and to assess its cost-effectiveness. RESEARCH DESIGN AND METHODS A total of 88 teens with type 1 diabetes from two sites were randomized into the READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls) intervention (IG) (n = 43) or standard care (SC) (n = 45) groups. During three diabetes clinic visits, IG subjects viewed a two-part CD-ROM, read a book, and met with a nurse. Program effectiveness was measured by knowledge, attitudes, intentions, and behaviors regarding diabetes, pregnancy, sexuality, and preconception counseling. Assessments occurred at baseline, before and after viewing program materials, and at 9 months. Economic analyses included an assessment of resource utilization, direct medical costs, and a break-even cost analysis. RESULTS Age range was 13.2–19.7 years (mean ± SD 16.7 ± 1.7 years); 6% (n = 5) were African American, and 24% (n = 21) were sexually active. Compared with baseline and SC subjects, IG subjects demonstrated a significant group-by-time interaction for benefit and knowledge of preconception counseling and reproductive health: increasing immediately after the first visit (P < 0.001) and being sustained for 9 months (P < 0.05 benefits; P < 0.001 knowledge). For IG subjects, preconception counseling barriers decreased over time (P < 0.001), and intention and initiation of preconception counseling and reproductive health discussions increased (P < 0.001). Costs of adverse reproductive outcomes are high. Direct medical costs of READY-Girls were low. CONCLUSIONS READY-Girls was beneficial and effects were sustained for at least 9 months. This low-cost self-instructional program can potentially empower young women with type 1 diabetes to make well-informed reproductive health choices, adding little time burden or cost to their diabetes management. © 2010 by the American Diabetes Association.