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, Katherine M Knauft, PhD Formal analysis, Visualization, Writing - original draft Department of Psychology, Wayne State University , 5057 Woodward Ave , Detroit, MI 48202, United States Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine , Detroit, MI, United States Corresponding author: Katherine Knauft, Department of Psychology, Wayne State University, 5057 Woodward Ave, Detroit, MI 48202, United States. Email: knauft@wayne.edu Search for other works by this author on: Oxford Academic Angela J Jacques-Tiura, PhD Formal analysis, Writing - review & editing Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine , Detroit, MI, United States Search for other works by this author on: Oxford Academic April Idalski Carcone, PhD Conceptualization, Data curation, Project administration, Validation, Writing - review & editing Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine , Detroit, MI, United States Search for other works by this author on: Oxford Academic Meredyth Evans, PhD Investigation, Project administration, Writing - review & editing Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago , Chicago, IL, United States Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine , Chicago, IL, United States Search for other works by this author on: Oxford Academic Jill Weissberg-Benchell, PhD Investigation, Project administration, Writing - review & editing Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago , Chicago, IL, United States Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine , Chicago, IL, United States Search for other works by this author on: Oxford Academic Colleen Buggs-Saxton, MD Investigation, Writing - review & editing Department of Pediatrics, Wayne State University School of Medicine , Detroit, MI, United States Search for other works by this author on: Oxford Academic Claudia Boucher-Berry, MD Investigation, Writing - review & editing Department of Pediatrics, University of Illinois School of Medicine at Chicago , Chicago, IL, United States Search for other works by this author on: Oxford Academic Jennifer L Miller, MD Investigation, Writing - review & editing Department of Pediatrics, Northwestern Feinberg School of Medicine , Chicago, IL, United States Search for other works by this author on: Oxford Academic Tina Drossos, PhD Investigation, Writing - review & editing Department of Psychiatry and Behavioral Neurosciences, University of Chicago Pritzker School of Medicine , Chicago, IL, United States Search for other works by this author on: Oxford Academic Bassem Dekelbab, MD Investigation, Writing - review & editing Pediatric Endocrinology, Corewell Health , Royal Oak, MI, United States Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-4017-6647 Deborah A Ellis, PhD Conceptualization, Formal analysis, Funding acquisition, Investigation, Project administration, Supervision, Validation, Writing - original draft Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine , Detroit, MI, United States Search for other works by this author on: Oxford Academic
Journal of Pediatric Psychology, jsae033, https://doi.org/10.1093/jpepsy/jsae033
Published:
22 May 2024
Article history
Received:
10 October 2023
Revision received:
11 April 2024
Accepted:
28 April 2024
Published:
22 May 2024
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Katherine M Knauft, Angela J Jacques-Tiura, April Idalski Carcone, Meredyth Evans, Jill Weissberg-Benchell, Colleen Buggs-Saxton, Claudia Boucher-Berry, Jennifer L Miller, Tina Drossos, Bassem Dekelbab, Deborah A Ellis, The moderating role of diabetes distress on the effect of a randomized eHealth intervention on glycemic control in Black adolescents with type 1 diabetes, Journal of Pediatric Psychology, 2024;, jsae033, https://doi.org/10.1093/jpepsy/jsae033
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Abstract
Objective
Due to systemic inequities, Black adolescents with type 1 diabetes are more likely to have suboptimal glycemic control and high rates of diabetes distress, but tailored interventions for this population are lacking. In primary outcomes of a randomized clinical trial, a family-based eHealth intervention improved glycemic control in Black adolescents with type 1 diabetes and elevated depressive symptoms. The present study is a secondary analysis of these clinical trial data examining the moderating effect of diabetes distress on the efficacy of the intervention.
Methods
Using secondary data from a multicenter randomized clinical trial (Clinicaltrials.gov [NCT03168867]), caregiver–adolescent dyads were randomly assigned to either up to three sessions of an eHealth parenting intervention (n = 75) or a standard medical care control group (n = 74). Black adolescents (10 years, 0 months to 14 years, 11 months old) with type 1 diabetes and a caregiver willing to participate were eligible. Adolescents reported their diabetes distress at baseline, and hemoglobin A1c (HbA1c) data were collected at baseline, 6-, 13-, and 18-month follow-up.
Results
No between-group contrasts emerged in a linear mixed-effects regression (p’s > .09). Within-group contrasts emerged such that adolescents assigned to the intervention who reported high diabetes distress had lower HbA1c at the 18-month follow-up relative to baseline (p = .004); the 18-month decrease in HbA1c was −1.03%.
Conclusions
Black adolescents with type 1 diabetes and high levels of diabetes distress showed significant decreases in HbA1c following a family-based eHealth intervention, suggesting diabetes distress may be a key moderator of intervention efficacy within this population.
adolescent diabetes, diabetes distress, parenting, disparities research, technology in health care
© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
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