Motivational Interviewing to Improve Self-Management in Youth with Type 1 Diabetes : A Randomized Clinical Trial

Authors' Affiliations

Kawther Al Ksir, College of Public Health, East Tennessee State University, Johnson City, Tennessee David L Wood, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee Yosra Hasni, Department of Endocrinology , Farhat Hached University Hospital Jihene Sahli, Department of Family and Community Medicine, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia Megan Quinn, College of Public Health, East Tennessee State University, Johnson City, Tennessee Meriam Ghardallou, Department of Family and Community Medicine, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia

Location

Culp Forum 311

Start Date

4-6-2022 9:00 AM

End Date

4-6-2022 10:00 AM

Faculty Sponsor’s Department

Pediatrics

Name of Project's Faculty Sponsor

david wood

Classification of First Author

Graduate Student-Doctoral

Competition Type

Competitive

Type

Oral Presentation

Project's Category

Diabetes, Endocrinologic Diseases

Abstract or Artist's Statement

Abstract:

Purpose: Effective interventions are needed to help adolescents with T1D develop independent self-management skills to prevent commonly observed deterioration of disease self-management resulting in poor health outcomes. Using a prospective RCT design, we assessed the impact of a nurse-led education program based on motivational interviewing (MI) in youth with Type 1 diabetes (T1D).

Design and methods: After parental consent and youth assent, we prospectively randomized 66 adolescents 13-18 years old with T1D to either usual care (every 3 months visit with pediatric endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls with a nurse educator in a pediatric endocrinology clinic of the University Hospital Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease specific self-management skills. Outcomes were change, between baseline and 6 months, in TRAQ (a validated measure of youth self-management) scores and HbA1c values.

Results: Mean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d. = 0.56) in the Intervention Group versus 0.26 points (s.d.= 0.34) in the control group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units versus a decrease of 0.12 units in the control group (p=0.047).

Conclusion: We found that a brief, nurse-led MI-based educational intervention, integrated into specialty pediatric care, resulted in a significant improvement in both self-reported self-management skills and in HbA1c values.

Trial registration: Registered in ClinicalTrials.gov Identifier: NCT04798937

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Apr 6th, 9:00 AM Apr 6th, 10:00 AM

Motivational Interviewing to Improve Self-Management in Youth with Type 1 Diabetes : A Randomized Clinical Trial

Culp Forum 311

Abstract:

Purpose: Effective interventions are needed to help adolescents with T1D develop independent self-management skills to prevent commonly observed deterioration of disease self-management resulting in poor health outcomes. Using a prospective RCT design, we assessed the impact of a nurse-led education program based on motivational interviewing (MI) in youth with Type 1 diabetes (T1D).

Design and methods: After parental consent and youth assent, we prospectively randomized 66 adolescents 13-18 years old with T1D to either usual care (every 3 months visit with pediatric endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls with a nurse educator in a pediatric endocrinology clinic of the University Hospital Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease specific self-management skills. Outcomes were change, between baseline and 6 months, in TRAQ (a validated measure of youth self-management) scores and HbA1c values.

Results: Mean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d. = 0.56) in the Intervention Group versus 0.26 points (s.d.= 0.34) in the control group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units versus a decrease of 0.12 units in the control group (p=0.047).

Conclusion: We found that a brief, nurse-led MI-based educational intervention, integrated into specialty pediatric care, resulted in a significant improvement in both self-reported self-management skills and in HbA1c values.

Trial registration: Registered in ClinicalTrials.gov Identifier: NCT04798937