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FL3X Study: An Adaptive Intervention to Improve Outcomes for Youth With Type 1 Diabetes (FL3X)

Not Applicable
Completed
Conditions
Type 1 Diabetes
Registration Number
NCT01286350
Lead Sponsor
University of North Carolina, Chapel Hill
Brief Summary

The purpose of this study is to see if a behavioral intervention for adolescents with type 1 diabetes will improve adherence to T1D self-management activities and improve diabetes outcomes. We expect the intervention to improve diabetes outcomes when compared to usual care.

Detailed Description

The FL3X Adaptive Intervention is designed to increase adherence to T1D self-management including medical management (blood sugar testing and insulin dosing), diet, and physical activity. FL3X relies on MI, and problem-solving skills training (PSST) as the basis for the counseling strategy, and creates a coherent integration across three key components of 1) behavior family systems therapy focused on family communications and teamwork; 2) individualized diabetes education in response to knowledge gaps relevant to behavioral goal attainment; and 3) use of currently available communications technology to support behavioral goal attainment through participant-defined reminders and motivational boosters, and/or peer support.

All FL3X intervention participants will receive "FL3X-Basic", which is the initial 3-month intervention that includes 4 sessions (40-60 min), supplemented with short additional contacts (via text, email, or web-based communication) as needed. Thereafter, applying principles of adaptive interventions, based on a decision rule using A1c values measured at defined intervals, participants are iteratively assigned to "FL3X-Check-in" or "FL3X-Regular", both of which continue with MI and PSST for the underlying counseling strategy. In FL3X-Check-in, participants who are doing well ("responders") will receive minimal ongoing support to reinforce successful strategies through brief monthly "touch-base" contacts. In FL3X-Regular, those who are "Regular-responders" will have a minimum of 3-4 in-person full-length sessions (40-60 min) over each 6-month interval, with additional brief contacts as needed (e.g., text, voice, or internet). FL3X participants randomized to the control group will receive usual care.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
258
Inclusion Criteria
  • type 1 diabetes with duration at least 12 months
  • between ages 12-16 years at registration
  • poor glycemic control (A1c 8.0-13.0%)
  • parent/guardian willing to also participate
  • not planning on moving in the following 18 months
Read More
Exclusion Criteria
  • pregnant (if female)
  • diabetes type 2 or gestational
  • Pre-existing systemic chronic disease (drug abuse, cancer, certain psychiatric conditions)
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Hemoglobin A1c0, 3, 6, 12, 18, 24, 30 months

HbA1c will be measured to determine impact on glucose control

Secondary Outcome Measures
NameTimeMethod
Problem solving skills0, 3, 6, 12, 18, 24, 30 months

Assess use of problem solving skills relative to diabetes care

Diabetes self-management behaviors0, 3, 6, 12, 18, 24, 30 months

Assess use of diabetes self-management behaviors

Motivation0, 3, 6, 12, 18, 24, 30 months

Motivation related to diabetes care will be assessed

Risk factors for diabetes complications0, 3, 6, 12, 18, 24, 30 months

Assess variables related to diabetes complications

Hypoglycemia0, 6, 18 mo

Monitoring low blood sugar from continuous glucose monitoring

Health-related quality of life0, 3, 6, 12, 18, 24, 30 months

Assess health-related quality of life

Trial Locations

Locations (2)

University of Colorado Barbara Davis Center for Childhood Diabetes

🇺🇸

Aurora, Colorado, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

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