Feasibility and Acceptability of a Self-guided Digital Family Skills Management Intervention for Children Newly Diagnosed with Type 1 Diabetes: A Pilot RCT (Preprint)

Abstract

Outcomes in children with type 1 diabetes (T1D) are influenced by psychosocial factors including family dynamics and parent and child psychological well-being. Early instruction for caregivers on evidence-based family management skills that support family adjustment to T1D immediately following diagnosis may improve glycemic outcomes. Self-guided digital interventions offer a sustainable model for clinic-wide interventions to support caregivers in learning these skills.

We hypothesized that a self-guided online family skills management program (addressing caregiver social support as well as family problem solving, communication, and supportive behavior change strategies) initiated at the time of type 1 diabetes (T1D) diagnosis would improve glycemic outcomes at 1 and 2 years post-diagnosis in children with T1D. In this study, we report on the feasibility and acceptability of this program.

We evaluated a sample of 37 children with newly diagnosed T1D. Parent participants were asked to complete online modules addressing social support, family problem solving, communication and supportive behavior change strategies. Module completion was analyzed for percent completion, patterns of completion and differences in completion rates by co-parenting status. Qualitative open-ended feedback was collected at the completion of each module.

84% of the 37 participants initiated the online program. 68% completed some content and 48% completed all five modules. Completion rates were higher when co-parenting partners engaged in the intervention together. Qualitative feedback supported the acceptability of the program for delivery soon after T1D diagnosis. Families reported on positive benefits, including requesting future access to the program and describing helpful changes in personal or family processes for managing T1D.

In this study, we found that a self-guided digital family support intervention initiated at the time of a child’s T1D diagnosis was largely feasible and acceptable. Self-guided digital programs addressing family management skills may help prevent challenges common with T1D management.

The study was pre-registered at clinicaltrials.gov: 1303325.