Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes

Author:

Bakhach Marwan1ORCID,Reid Mark W.1,Pyatak Elizabeth A.2,Berget Cari3,Cain Cindy3,Thomas John “Fred”456,Klingensmith Georgeanna J.3,Raymond Jennifer K.1

Affiliation:

1. Children’s Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California

2. Chan Division of Occupational Science and Occupational Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California

3. Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, Colorado

4. Department of Telehealth, School of Medicine, University of Colorado, Aurora, Colorado

5. Department of Psychiatry, School of Medicine, University of Colorado, Aurora, Colorado

6. Department of Epidemiology, School of Public Health, University of Colorado, Aurora, Colorado

Abstract

Purpose To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D). Methods YAs self-selected to participate in the CoYoT1 Clinic or serve as a usual care control. CoYoT1 Clinic visits consisted of an individual appointment with a provider and a group appointment with other YAs with T1D using home telemedicine. Psychosocial and behavioral functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy for Diabetes Scale, Self-Management of Type 1 Diabetes in Adolescence Scale, and Center for Epidemiologic Studies Depression Scale. Results Forty-two patients participated in the CoYoT1 Clinic and 39 patients served as controls. CoYoT1 participants reported lower levels of distress ( P = .03), increased diabetes self-efficacy ( P = .01), and improved ability to communicate with others about diabetes ( P = .04) over the study period compared to controls. YA males in the control group reported increases in depressive symptoms ( P = .03) during the study period, but CoYoT1 participants showed no changes. Conclusion Group home telemedicine for YAs with T1D positively affects diabetes distress, self-efficacy, and diabetes-specific communication. These positive findings have the potential to also affect the YAs’ long-term diabetes outcomes. Further investigation of the model is needed.

Funder

The Leona M. and Harry B. Helmsley Charitable Trust

Gustavus and Louise Pfeiffer Research Foundation

Publisher

SAGE Publications

Subject

Health Professions (miscellaneous),Endocrinology, Diabetes and Metabolism

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