Improving Diabetes in Emerging Adulthood (IDEA)
Diabetes Mellitus, Type 1
About this trial
This is an interventional treatment trial for Diabetes Mellitus, Type 1 focused on measuring emerging adults, ehealth intervention, diabetes, diabetes management, adolescents, self-determination theory
Eligibility Criteria
Inclusion:
- Age 16 years, 0 months - 25 years, 11 months
- Type 1 diabetes (T1D)
- HbA1c ≥7.5% currently and averaged over the previous 6 months
- Duration of diabetes ≥6 months
- English fluency, both verbal and written
Cell phone access with texting capability
Exclusion:
- Psychosis (e.g., schizophrenia or bipolar disorder)
- Suicidal
- Developmental delay (moderate or severe mental retardation, or autism) or reading level below sixth grade
- The presence of another physical health condition that results in atypical diabetes management (e.g., cystic fibrosis)
Sites / Locations
- Detroit Medical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
No Intervention
Question Prompt List (QPL)
Motivation Enhancement System (MES)
Text Message Reminders (TXT)
QPL & MES
QPL & TXT
MES & TXT
MES, QPL & TXT
Standard Medical Care
A QPL is a simple, inexpensive communication tool that is comprised of list of questions related to the physical and psychosocial aspects of an illness and treatment components about which patients may want to ask their diabetes care team during a routine diabetes clinic visit.
MES is a brief, 2-session computer-delivered intervention to enhance intrinsic motivation for behavior change. MES is grounded in the Motivational Interviewing framework and the Information-Motivation-Behavioral Skills model of health behavior change. Session 1 begins with psychoeducation describing optimal diabetes self-management, then youth motivation for diabetes self-management is assessed and followed by exercises designed to increase or reinforce his/her current motivational state (e.g., decisional balance) and build self-efficacy, (e.g., building on strengths and past success). Session 1 concludes with goal setting to promote autonomous diabetes self-management. Session 2 begins with an assessment of progress toward the behavioral goal and proceeds to build motivation and self-efficacy with exercises consistent with the youth's current motivational state. Session 2 concludes with goal setting to promote autonomous diabetes self-management.
Participants will receive 30 days of one-way text messages targeting one of three key daily diabetes care behaviors: monitoring blood glucose, insulin administration, or carbohydrate counting. Participants will set a reminder schedule, i.e., frequency and timing of text message reminders.
Participants will receive the QPL and MES interventions as described above.
Participants will receive the QPL and TXT interventions as described above.
Participants will receive the MES and TXT interventions as described above.
Participants will receive the MES, QPL, and TXT interventions as described above.
Participants will receive standard medical care at one of two participating clinical sites. Clinical practices at these sites are consistent with the standards of T1D care recommended by the American Diabetes Association and will include diabetes clinic visits every 3-4 months for routine diabetes medical care provided by an endocrinologist and/or nurse practitioner.