Depression Moderates the Effects of an eHealth Intervention on Glycemic Control of Black Youth with Type 1 Diabetes: Findings from a Multi-Center, Randomized Clinical Trial (Preprint)

Abstract

Black adolescents with type 1 diabetes (T1D) are at increased risk for sub-optimal diabetes health outcomes; however, evidence-based interventions for this population are lacking. Depression affects a high percentage of youth with T1D and increases the likelihood of problems with diabetes health.

To test whether baseline levels of depression moderated the effects of a brief, eHealth parenting intervention delivered to caregivers of young Black adolescents with T1D on youths’ glycemic control.

A multi-center randomized clinical trial was conducted at seven pediatric diabetes clinics located in two large US cities. Participants (N=149) were allocated to either intervention or standard medical care control. Up to three intervention sessions were delivered on a tablet computer during diabetes clinic visits over a 12-month period.

In a linear mixed effects regression model, planned contrasts did not show significant reductions in HbA1c for intervention adolescents in comparison to controls. However, adolescents with higher baseline levels of depressive symptoms who received the intervention had significantly greater improvements in HbA1c at 6-month follow-up (0.94%, P = .012) and 18-month follow-up (1.42%, P=.002) than those with lower levels of depression. Within the intervention group, adolescents had a statistically significant reduction in HbA1c from baseline at 6-month and 18-month follow-up.

A brief, culturally tailored, eHealth parenting intervention improved health outcomes among Black adolescents with type 1 diabetes and depressive symptoms.

The trial was registered in clinicaltrials.gov under registry number NCT03168867.