Support-t, an Online Training and Peer Support Platform to Accompany Youth Living With Type 1 Diabetes Transitioning to Adult Healthcare
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Diabetes Mellitus
- Sponsor
- Anne-Sophie Brazeau
- Enrollment
- 200
- Locations
- 4
- Primary Endpoint
- Change from Baseline Hemaglobin A1c (HbA1c) at 18 months
- Status
- Recruiting
- Last Updated
- 7 months ago
Overview
Brief Summary
The investigators will conduct a randomized controlled trial (RCT) to examine how an online training and peer support platform could help the preparation to transition to adult care. Among 14-16 year old youth with Type 1 Diabetes (T1D), the investigators aim to assess the effect of an online training and peer support platform (Support-t) integrated in usual care, compared with usual care on Hemoglobin A1c (HbA1c), adverse outcomes and psychosocial measures during the preparation for transition to adult care. The investigators will conduct a multi-site, parallel group, blinded (outcome assessors, data analysts), superiority RCT of adolescents with T1D (14-16 years of age) followed at one of 4 university teaching hospital-based pediatric diabetes clinics in the province of Quebec.
Detailed Description
The transition from pediatric to adult diabetes care is a challenging period for adolescents and young adults living with chronic conditions, such as Type 1 Diabetes (T1D). For youth with T1D, transition from pediatric to adult care is characterized by deterioration in glycemic control (Hemoglobin A1c \[HbA1c\]), reduced adherence to diabetes management tasks and increased risk of diabetes complications. The investigators propose to examine an online training and peer support platform as a potential alternative for delivering transition care. In adolescents with T1D, the investigators hypothesize that an online training and peer support platform (Support-t), when integrated into usual pediatric care, as compared with usual care alone, will result in better HbA1c, less adverse outcomes and better psychosocial outcomes during the preparation for transfer to adult care. Primary Aim: To determine the impact of adding access to Support-t to usual care compared with usual care alone, on HbA1c during the preparation for transfer to adult care. Secondary Aims: To determine the impact of adding access to Support-t to usual care compared with usual care alone, on self-efficacy, diabetes distress, quality of life (QOL; diabetes specific), readiness to transfer to adult care, glucose management, severe hypoglycemic episodes, diabetic ketoacidosis (DKA), T1D-related ED-visits and hospitalizations during the preparation for transfer to adult care. 2. To determine the cost-effectiveness of Support-t. 3. To understand the context for implementation in regards to level of engagement on Support-t, satisfaction and experience (barriers, facilitators) with Support-t. Methods: The investigators will conduct a multi-site, parallel group, blinded (outcome assessors, data analysts), superiority RCT of adolescents with T1D (14-16 years of age) followed at one of 4 university teaching hospital-based pediatric diabetes clinics in Quebec. Patients will be recruited over 20 months. Interventions will occur over 18 months. Follow-up will be to 18 months from enrollment. Allocation will be concealed with a 1:1 intervention to control ratio. Participants in the active arm will have access to a mobile-based online training and peer support platform (Support-t) added to usual care. Participants in the control group will have in parallel with the intervention group, their usual diabetes care. The primary outcome is the change in HbA1c measured at 18 months (HbA1c measured at 18 months - HbA1c measured at baseline). Secondary outcomes are self-efficacy, diabetes distress, QOL, readiness to transfer, glucose management, severe hypoglycemic episodes, DKA, T1D-related ED-visits and hospitalizations. Assessments are at baseline, 6, 12 and 18 months. Analysis will be by intention-to-treat. Outcomes will be calculated and compared between the 2 trial arms using differences with 95% Confidence Intervals, along with a cost-effectiveness analysis. Interviews will be conducted to analyze the context for implementation.
Investigators
Anne-Sophie Brazeau
Associate Professor
McGill University
Eligibility Criteria
Inclusion Criteria
- •Adolescents with a clinical diagnosis of T1D
- •14-16 years of age
- •Receiving diabetes care at one of 4 university teaching hospital-based pediatric diabetes clinics in Quebec: Montreal Children's Hospital-McGill University Health Centre, Centre hospitalier universitaire de Sherbrooke, Le Copain-Hôpital de Gatineau, Centre Hospitalier Universitaire de Québec
- •Having access to internet
- •Having an active email address
- •Fluent in English or French
Exclusion Criteria
- •Severe neurocognitive disabilities
- •Patients with conditions associated with shortened erythrocyte survival, such as hemolytic anemia or other conditions associated with inaccurate HbA1c
Outcomes
Primary Outcomes
Change from Baseline Hemaglobin A1c (HbA1c) at 18 months
Time Frame: 18 months
HbA1c measured with a venous or capillary blood sample as part of the standard of diabetes care will be derived from the medical record chart or measured using an A1c Test Kit, which is a non-fasting, finger prick, whole blood test
Secondary Outcomes
- Continuous Glucose Monitoring (CGM) - % Time above range(0, 6, 12, 18 months)
- Continuous Glucose Monitoring (CGM) - % Time in range(0, 6, 12, 18 months)
- Diabetes-related hospitalizations(0, 6, 12, 18 months)
- Diabetes-related emergency department visits(0, 6, 12, 18 months)
- Diabetes distress(0, 6, 12, 18 months)
- Cost effectiveness (QOL)(12 and 18 months)
- Change from Baseline Hemaglobin A1c (HbA1c) at 6 and 12 months(6, 12 months)
- Continuous Glucose Monitoring (CGM) - % Time below range(0, 6, 12, 18 months)
- Continuous Glucose Monitoring (CGM) - Standard deviation(0, 6, 12, 18 months)
- Transition readiness(0, 6, 12, 18 months)
- Continuous Glucose Monitoring (CGM) - % Coefficient of variation(0, 6, 12, 18 months)
- Diabetic Ketoacidosis (DKA) events(0, 6, 12, 18 months)
- Cost effectiveness (HbA1c)(12 and 18 months)
- Cost effectiveness (self-efficacy)(12 and 18 months)
- Cost effectiveness (diabetes distress)(12 and 18 months)
- Severe hypoglycemic events(0, 6, 12, 18 months)
- Self-efficacy(0, 6, 12, 18 months)
- Diabetes specific Quality of Life (QOL)(0, 6, 12, 18 months)