Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study

Background Family conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions. Objective The purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent. Methods Parent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245). Results Twenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach. Conclusions The Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.5817

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Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study (Preprint)

10.2196/preprints.15318 ◽

2019 ◽

Author(s):

Debbe Thompson ◽

Chishinga Callender ◽

Caroline Gonynor ◽

Karen W Cullen ◽

Maria J Redondo ◽

...

Keyword(s):

Type 1 Diabetes ◽

Pilot Study ◽

Therapeutic Alliance ◽

Diabetes Management ◽

Online Intervention ◽

Program Satisfaction ◽

The Family ◽

Diabetes Family ◽

Relational Agent

BACKGROUND Family conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions. OBJECTIVE The purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent. METHODS Parent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245). RESULTS Twenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach. CONCLUSIONS The Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/resprot.5817

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POLA RESPON KELUARGA DALAM MANAJEMEN DIABETES ANAK DENGAN DIABETES TIPE 1 DI IKATAN DIABETES ANAK DAN REMAJA (IKADAR) KOTA MALANG

Jurnal Kesehatan Mesencephalon ◽

10.36053/mesencephalon.v6i1.189 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Aloysia Ispriantari

Keyword(s):

Type 1 Diabetes ◽

Diabetes Management ◽

Health Workers ◽

Family Responsibility ◽

Perfect Agreement ◽

Purposive Sampling ◽

The Family ◽

Almost All ◽

Diabetes Family

Type 1 diabetes is the type of diabetes that most occurs in childhood. The complexity of management of type 1 diabetes requires a large role from the family in monitoring and managing diabetes owned by children. The purpose of this study was to determine the pattern of family response in the diabetes management in children with type 1 diabetes in IKADAR Malang. This research was a descriptive study. The populations were all children with their parents in IKADAR Malang. The respondents of this study were 19 children and 19 parents in IKADAR Malang taken by purposive sampling. The variable was the pattern of family response measured by using the Diabetes Family Responsibility Questionnaire (DFRQ) questionnaire. It was found that the pattern of family response in diabetes management is the perfect agreement pattern of 10.1 ± 3.2, the overlap pattern of 6.7 ± 3.3 and the pattern of no responsibility that is equal to 0.2 ± 0, 4 which can be interpreted that almost all (82.3%) diabetes management tasks have been fulfilled and only a small portion (17.7%) tasks have not been fulfilled. It can be expected that nurses can assist the family so that the diabetes management is fully achieved and help children begin to learn to manage diabetes independently with the supervision of a team of health workers and parents. Keywords: The Pattern of Family Response, Diabetes Management, Children, Type 1 Diabetes Abstrak : Diabetes tipe 1 merupakan tipe diabetes yang paling banyak terjadi di masa anak-anak. Kompleksitas manajemen diabetes tipe 1 ini membutuhkan peran besar dari keluarga dalam mengawasi dan mengelola diabetes yang dimiliki oleh anak. Tujuan penelitian ini adalah untuk mengetahui pola respon keluarga dalam manajemen diabetes anak dengan diabetes tipe 1 di Ikatan Diabetesi Anak dan Remaja (IKADAR) Kota Malang. Penelitian ini adalah penelitian deskriptif. Populasi dalam penelitian ini adalah seluruh anak beserta orang tuanya yang tergabung dalam IKADAR Kota Malang. Sampel penelitian ini sebanyak 19 anak dan 19 orang tuanya yang tergabung di IKADAR (Kota Malang yang diambil secara purposive sampling. Variabel penelitian adalah pola respon keluarga yang diukur dengan menggunakan kuisioner Diabetes Family Responsibility Questionnaire (DFRQ). Didapatkan hasil bahwa pola respon keluarga dalam manajemen diabetes yaitu pola persetujuan sempurna sebesar 10,1 ± 3,2, pola overlap sebesar 6,7 ± 3,3 dan pola tidak ada yang bertanggung jawab yaitu sebesar 0,2 ± 0,4 yang dapat diartikan bahwa hampir seluruhnya (82,3%) tugas manajemen diabetes telah terpenuhi dan hanya sebagian kecil (17,7%) tugas yang belum terpenuhi. Diharapkan perawat dapat mendampingi keluarga agar manajemen diabetes anak tercapai penuh serta membantu anak agar mulai belajar mengelola diabetesnya secara mandiri dengan tetap dalam pengawasan tim tenaga kesehatan dan orang tua. Kata kunci: Pola Respon Keluarga, Manajemen Diabetes, Anak, Diabetes Tipe 1

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Support Group for Parents Coping with Children with Type 1 Diabetes / Skupina Za Starše Kot Podpora Družinam Pri Soočanju Z Otrokovo Sladkorno Boleznijo Tipa 1

Slovenian Journal of Public Health ◽

10.1515/sjph-2015-0012 ◽

2015 ◽

Vol 54 (2) ◽

pp. 79-85 ◽

Cited By ~ 2

Author(s):

Tanja Pate ◽

Miha Rutar ◽

Tadej Battelino ◽

Maja Drobnič Radobuljac ◽

Nataša Bratina

Keyword(s):

Type 1 Diabetes ◽

Support Group ◽

Parental Support ◽

Diabetes Management ◽

Good Practice ◽

Evaluation Questionnaire ◽

The Family ◽

Almost All ◽

The Impact

Abstract Objectives. Type 1 diabetes is one of the most common chronic diseases in childhood. Active parental involvement, parental support in the diabetes management and family functioning are associated with optimal diabetes management and glycemic control. The purpose of this study was to assess parental satisfaction with participation in the group and their perceptions of the impact of the intervention on living and coping with childrens T1D. Methods. A sample of 34 parents of children with T1D participated in this trend study. The participants’ experience and satisfaction with support group was measured by a self- evaluation questionnaire, designed for the purpose of the present study. Results. Quantitative data show that parents were overall satisfied with almost all measured items of the evaluation questionnaire (wellbeing in the group, feeling secure, experiencing new things, being able to talk and feeling being heard) during the 4-year period. However, parents from the second and third season, on average, found that the support group has better fulfilled their expectations than the parents from the first season (p = 0,010). The qualitative analysis of the participants’ responses to the open-ended questions was underpinned by four themes: support when confronting the diagnosis, transformation of the family dynamics, me as a parent, exchange of experience and good practice and facing the world outside the family. Discussion. The presented parent support group showed to be a promising supportive, therapeutic and psychoeducative space where parents could strengthen their role in the upbringing of their child with T1D.

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