This competing continuation application seeks support for a significant extension of our current studies of the effects of a behavioral intervention, coping skills training (CST), for children and adolescents with type 1 diabetes (TID) and their parents.
The specific aims for this application are: (1) Using a prospective, clinical trial design, we will determine the effect of booster CST sessions once school-age children reach adolescence on physiologic (serial Hemoglobin Alc (HbAlc), adverse events) and psychosocial adaptation (depressive symptoms and quality of life (QoL) in the children; depressive symptoms, coping, and adaptability in the parents; adaptability, conflict, diabetes behaviors in the family). (2) Using a prospective, randomized clinical trial design, we will determine the effect of CST conducted with parents of children with T1D less than 8 years of age on improving parental (QoL, fear of hypoglycemia, anxiety, and depressive symptoms) and family psychosocial adaptation (family adaptability, cohesion, conflict, and responsibility sharing) as compared to parents who receive a time-equivalent educational intervention. To achieve aim 1, we will maintain 60 subjects in our current study and enroll 30 more (age 8-12) with T1D and one of their parents and randomly assign them to one of two groups: a booster intervention at age 13-14 or education. Booster CST consists of a series of small group efforts designed to help youth cope with the management of their disease and will build on our previously successful work with teens. Both groups will receive intensive DM management from an established team of providers. Data will be collected pre and post intervention and at 6, and 12 months following using HbAlc, Self-Efficacy for Diabetes Scale, Children's Depression Inventory, Issues in Coping with IDDM-Child, and the Diabetes Quality of Life: Youth, Diabetes Family Behavior Scale for the children, and the Diabetes Responsibility & Conflict, Issues in Coping with IDDM-Parent, and FACES II scales in the parents. To meet aim 2, we will enroll 134 parents of young children (< 8 years of age) and randomly assign them to either CST or education. Similar parent and child outcomes will be collected at 0, 3, 6, and 12 months. It is expected that this important and timely study will yield valuable information to help other youth manage this devastating disease, and move our work from simple efficacy studies to effectiveness across groups.
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