Abstract
Purpose
Effective interventions are needed to help adolescents with T1D develop independent
self-management skills to prevent commonly observed deterioration of disease self-management
resulting in poor health outcomes. Using a prospective RCT design, we assessed the
impact of a nurse-led education program based on motivational interviewing (MI) in
youth with Type 1 diabetes (T1D).
Design and methods
After parental consent and youth assent, we prospectively randomized 66 adolescents
13–18 years old with T1D to either usual care (every 3 months visit with pediatric
endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls
with a nurse educator in a pediatric endocrinology clinic of the University Hospital
Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease
specific self-management skills. Outcomes were change, between baseline and 6 months,
in TRAQ (a validated measure of youth self-management) scores and HbA1c values.
Results
Mean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d.
= 0.56) in the Intervention Group versus 0.26 points (s.d. = 0.34) in the control
group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units
versus a decrease of 0.12 units in the control group (p = 0.047).
Conclusion
We found that a brief, nurse-led MI-based educational intervention, integrated into
specialty pediatric care, resulted in a significant improvement in both self-reported
self-management skills and in HbA1c values.
Trial registration: Registered in ClinicalTrials.gov Identifier: NCT04798937
Keywords
Abbreviations:
MI (Motivational Interviewing), HCT (Health Care Transition)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 11, 2022
Accepted:
May 4,
2022
Received in revised form:
April 23,
2022
Received:
January 23,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
