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Improving Transition Care for Adolescents and Young Adults With Type 1 Diabetes

Not Applicable
Recruiting
Conditions
Type 1 Diabetes
Interventions
Other: Educational materials
Behavioral: Transition preparation program
Registration Number
NCT05639088
Lead Sponsor
Virginia Commonwealth University
Brief Summary

The purpose of this research study is to evaluate a transition preparation program designed for adolescents and young adults (AYAs) with type 1 diabetes (T1D). This transition program will support AYAs as they prepare to transition from pediatric to adult endocrinology medical care and will also include a caregiver. Results from this study will inform clinical recommendations regarding self-management best practices for AYAs with T1D prior to transitioning to adult medical care.

Detailed Description

Investigators will recruit adolescents and young adults ages 16-22 years with T1D and a parent/guardian. Families will participate in one of two 6-month treatments: 1) SHIFT2, engaging in monthly sessions with transition coaches providing education on diabetes management and healthcare transition, or 2) Enhanced treatment (TAU+), engaging in routine medical care and receiving monthly education (no coaches).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
115
Inclusion Criteria

AYA:

  1. Type 1 Diabetes diagnosis for at least 1 year (as documented in medical record)
  2. 16-22 years old
  3. English speaking
  4. Children's Hospital of Richmond patient (Division of Pediatric Endocrinology)
  5. must have a caregiver willing to participate

Caregiver:

  1. Age greater than 18 years
  2. Provides care to AYA and willing to participate
Exclusion Criteria

AYA:

  1. Non-English speaking
  2. Significant psychiatric, cognitive, medical or developmental conditions that would impair their ability to complete assessments and/or engage in diabetes self-care behaviors (e.g., malignancies, psychosis, intellectual disability
  3. Hospitalization for depression, suicidal ideation or other psychiatric disorder within the past 12 months. Life time history of psychotic disorder
  4. Medically-induced diabetes or diagnosis of diabetes other than type 1 diabetes.
  5. Currently pregnant, pregnant within the past 6 months, currently breastfeeding or planning to become pregnant within the next 12 months.
  6. Another member of the household (other than the participating parent) is a participant or staff member on this study.
  7. Participation in another research study that may interfere with this study.
  8. Previous participation in the SHIFT pilot study

Caregiver:

  1. Non-English speaking
  2. Significant psychiatric, cognitive, developmental conditions that would impair their ability to complete assessments and/or engage in supporting the AYA with diabetes self-care behaviors (e.g., psychosis, intellectual disability)
  3. Another member of the home (not AYA) is a participant/staff member on current study
  4. Participation in another research study that may interfere with current study
  5. Previous participation in SHIFT pilot study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group B: TAU+/ControlEducational materialsParticipants will engage in routine medical visits and will receive education materials monthly (1x/month) regarding healthcare transition and diabetes management.
Group A: SHIFT2Transition preparation programAdolescents and young adults will engage in routine medical visits and attend 6 sessions (1x/month) focused on transition preparation and diabetes management with a transition coach and will receive bi-weekly messages during these 6-months that encourage self-management behaviors. Parents will attend 2 sessions (month 1 and 6) with a transition coach and will receive materials, complementing their child's lesson, 1x/month for months 2-5 that focus on transition their role and supporting their child's diabetes management.
Primary Outcome Measures
NameTimeMethod
Hemoglobin A1C (HbA1C)6 months

HbA1C will be assessed using a standard assay from a routine blood draw or an at-home testing kit

Change in transition readinessBaseline to 6 months

Transition readiness will be measured using the Readiness Assessment of Emerging Adults with Type 1 Diabetes Diagnosed in Youth (READDY) scale, which will be completed by AYAs.

Attendance at clinic visits6 months

Attendance at routine clinic visits will be determined from medical records and will be assessed by the number of regularly scheduled visits attended.

Change in diabetes adherenceBaseline to 6 months

Diabetes adherence will be assessed using the Self-Care Inventory-Revised, which will be completed by both AYA and caregivers.

Secondary Outcome Measures
NameTimeMethod
Change in diabetes supportBaseline to 12 months

Diabetes support will be assessed using the Diabetes Social Support Questionnaire - Family Version (DDSQ-Family), which will be completed by AYAs.

Attendance at clinic visits12 months

Attendance at routine clinic visits will be determined from medical records.

HbA1C12 months

HbA1C will be assessed using a standard assay from a routine blood draw or an at-home testing kit.

Diabetes-related events12 months

Number of diabetes-related events will be determined from medical records

Change in transition readinessBaseline to 12 months

Transition readiness will be measured using the Readiness Assessment of Emerging Adults with Type 1 Diabetes Diagnosed in Youth (READDY) scale, which will be completed by AYAs.

Change in diabetes adherenceBaseline to 12 months

Diabetes adherence will be assessed using the Self-Care Inventory-Revised, which will be completed by both AYA and caregivers.

Change in Diabetes DistressBaseline to 12 months

Diabetes distress will be assessed using the Diabetes Distress Scale (DDS) for Type 1 Diabetes (DDS), which will be completed by both AYA and caregivers. AYA will complete specific versions corresponding to age (\>18 or \<18) and caregivers complete their own version of the measure.

Change in Self EfficacyBaseline to 12 months

Self-efficacy will be measured using the Self-efficacy for Diabetes Self-Management scale (SEDSM), which will be completed by AYAs.

Change in Quality of LifeBaseline to 12 months

Quality of life will be measured using the T1D and Life (T1DAL), which will be completed by AYA and caregiver.

Trial Locations

Locations (1)

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

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