Problems with adherence in adolescents with type 1 diabetes are common - occurring at rates as high as 93% - and have serious health consequences, including suboptimal glycemic control and risk for later complications. Yet, previous interventions to improve adherence in adolescents with type 1 diabetes have only shown modest to moderate effects, and many have been time-intensive and expensive. Thus, there is a need for novel interventions to improve adherence in adolescents with type 1 diabetes. Increasing positive affect (e.g., feeling happy, cheerful, proud) has been shown to promote adherence to treatment recommendations in adult populations. We propose to develop, revise, and pilot test a positive psychology intervention for adolescents with type 1 diabetes aimed at increasing motivation for adherence. This innovative intervention would induce positive affect in adolescents (age 13-17) through tailored exercises in gratitude, self-affirmation, small gifts, and parent affirmations to promote adherence. Specifically, we aim to increase the frequency of blood glucose monitoring, which is one of the best indicators of adherence and is strongly linked to glycemic control. We will also explore the use of technology, by developing and comparing telephone-administered vs. automated text- messaging versions of the intervention, to determine which mode of delivery is more appealing and convenient for adolescents. The study will be conducted by a multidisciplinary team, consisting of Sarah Jaser, PhD, a pediatric psychologist, and two collaborators, Robin Whittemore, PhD, APRN, a nurse researcher, and Stuart Weinzimer, MD, a pediatric endocrinologist. We believe that this low-cost positive psychology intervention has the potential to increase adolescents'motivation for performing blood glucose monitoring without adding to the burden of treatment management. Results from the proposed study will provide the basis for a large scale randomized clinical trial of the intervention.

Public Health Relevance

The proposed study has the potential to improve adherence to the diabetes regimen in adolescents with type 1 diabetes without compromising their quality of life. The potential benefits include helping adolescents achieve better glycemic control, thereby reducing the health risks and complications associated with diabetes.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type 1 Diabetes Targeted Research Award (DP3)
Project #
Application #
Study Section
Special Emphasis Panel (ZDK1-GRB-9 (O1))
Program Officer
Hunter, Christine
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Vanderbilt University Medical Center
Schools of Medicine
United States
Zip Code
Zhang, Shuodan; Hamburger, Emily; Kahanda, Sachini et al. (2018) Engagement with a Text-Messaging Intervention Improves Adherence in Adolescents with Type 1 Diabetes: Brief Report. Diabetes Technol Ther 20:386-389
Bergner, Erin M; Whittemore, Robin; Patel, Niral J et al. (2018) Participants' Experience and Engagement in Check It!: a Positive Psychology Intervention for Adolescents with Type 1 Diabetes. Transl Issues Psychol Sci 4:215-227
Patel, Niral J; Savin, Kimberly L; Kahanda, Sachini N et al. (2018) Sleep habits in adolescents with type 1 diabetes: Variability in sleep duration linked with glycemic control. Pediatr Diabetes :
Savin, Kimberly L; Hamburger, Emily R; Monzon, Alexandra D et al. (2018) Diabetes-specific family conflict: Informant discrepancies and the impact of parental factors. J Fam Psychol 32:157-163
Datye, Karishma A; Patel, Niral J; Jaser, Sarah S (2017) Measures of Adherence and Challenges in Using Glucometer Data in Youth with Type 1 Diabetes: Rethinking the Value of Self-Report. J Diabetes Res 2017:1075428
Perez, Katia M; Patel, Niral J; Lord, Jadienne H et al. (2017) Executive Function in Adolescents With Type 1 Diabetes: Relationship to Adherence, Glycemic Control, and Psychosocial Outcomes. J Pediatr Psychol 42:636-646
Jaser, Sarah S; Ellis, Deborah (2016) Sleep in Adolescents and Young Adults with Type 1 Diabetes: Associations with Diabetes Management and Glycemic Control. Health Psychol Behav Med 4:49-55
Jaser, Sarah S; Patel, Niral; Linsky, Rebecca et al. (2014) Development of a positive psychology intervention to improve adherence in adolescents with type 1 diabetes. J Pediatr Health Care 28:478-85
Jaser, Sarah S; Patel, Niral; Rothman, Russell L et al. (2014) Check it! A randomized pilot of a positive psychology intervention to improve adherence in adolescents with type 1 diabetes. Diabetes Educ 40:659-67