ABSTRACT
BACKGROUND: Managing type 1 diabetes mellitus (T1DM) in preschool-aged children has unique challenges that can negatively impact glycemic control and parental coping. OBJECTIVE: To evaluate the impact of a camp-based multi-component intervention on glycated hemoglobin A1c (HbA1c) in young children with T1DM and psychosocial measures for their parents. SUBJECTS AND METHODS: Two separate cohorts of 18 children (ages 3-5 years) and their families participated in a camp-based intervention that included didactic and interactive parent education, child-centered education and family-based recreational activities. In Camp 1.0, measures of HbA1c, parental fear of hypoglycemia, mealtime behaviors and quality of life (QOL) were compared before and after an initial session (I) and follow-up booster session (II) 6 months later. Based on these results, the intervention was consolidated into 1 session (Camp 2.0) and repeated with additional measures of parental stress and parental self-efficacy with diabetes management tasks. RESULTS: Participants in Camp 2.0 exhibited a significant decrease in mean HbA1c level (-0.5%, P = .002) before and after camp. Mothers exhibited a significant improvement in diabetes-specific QOL (Camp 1.0/Session I and Camp 2.0) and reduction in stress as measured on the Pediatric Inventory for Parent (PIP) assessment (Camp 2.0). The booster session in Camp 1.0 showed no added benefit. CONCLUSIONS: A family centered, camp-based multi-component intervention in young children with T1DM improved HbA1c and perceived QOL and stress in their mothers.
Subject(s)
Diabetes Mellitus, Type 1/therapy , Health Education/methods , Parents/education , Age of Onset , Caregivers/education , Caregivers/psychology , Child , Child, Preschool , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/psychology , Family/psychology , Feasibility Studies , Female , Health Education/organization & administration , Humans , Leisure Activities , Male , Parent-Child Relations , Parents/psychology , Pilot ProjectsABSTRACT
OBJECTIVE To compare motivational interviewing-based education (MI) and structured diabetes education (SDE) for improving A1C and psychosocial measures in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS This study was a 9-month randomized controlled trial comparing MI (n = 21) to SDE (n = 23). Interventions were at baseline (T0) and 3 months (T1), with A1C and psychosocial measures obtained at 6 months (T2) and 9 months (T3). RESULTS Over the 6 months of follow-up, the SDE group had lower adjusted mean A1C value (least squares mean 10.31, SE 0.32) than the MI group (least squares mean 11.35, SE 0.34) (P = 0.03, d = -0.66). There were no differences on any of the psychosocial measures. CONCLUSIONS SDE is effective at improving metabolic control in adolescents with type 1 diabetes. Diabetes educators were proficient in learning MI.
Subject(s)
Counseling , Diabetes Mellitus, Type 1/psychology , Motivation , Adolescent , Child , Diabetes Mellitus, Type 1/metabolism , Female , Glycated Hemoglobin/metabolism , Humans , Interviews as Topic , Male , Patient Education as TopicABSTRACT
OBJECTIVE: To evaluate the effects of a hospital-based, family-centered lifestyle program (Kids N Fitness) on weight and health in overweight 7-17-year-old children. DESIGN: The Kids N Fitness program consisting of up to twelve 90-min sessions was conducted in an outpatient setting. The program comprised interactive nutrition and exercise sessions with behavior modification. Subjects completed a logbook and child's health questionnaire. Measures and surveys were taken before, during, and after the program. PARTICIPANTS: Two hundred and sixty-four overweight children (137 female, 73% Hispanic), mean age 11.5+/-2.1 years, with body mass index (BMI)=85th percentile, no physical limitations, and attendance of >or=50% of sessions. A subgroup of 115 children was observed for up to 6 months prior to program. INTERVENTION RESULTS: Weight and BMI velocity, and BMI, and BMI z-score were lower during the program than during the pre-program observation period. Compared, subjects in the 12-week program had significantly reduced gains in weight and greater losses in body mass index, than in 8 weeks. Improvements in emotional well-being and behavior correlated positively with weight loss (p=0.005). CONCLUSIONS: Positive health outcomes suggest that family-centered programs, stressing healthy eating strategies, participation in team-oriented physical activities, and behavior modification, are effective in improving weight dynamics and psychological functioning.
