Intervention Groups for Adolescents With Type 1 Diabetes Mellitus

November 16, 2011 updated by: Jessica C. Kichler, Children's Hospital and Health System Foundation, Wisconsin

Adjustment and Self-Management Intervention Groups for Adolescents With Type 1 Diabetes Mellitus and Their Parents.

The purpose of this study is to utilize a group therapy adjustment and coping program at the Children's Hospital of Wisconsin with patients who have Type 1 Diabetes Mellitus (T1DM) and their parents within a "typical" clinical condition of patients who have been referred for outpatient therapy services. To extend the previous literature on these types of peer and family-based groups to include survey data as well as provider ratings, medical data, and add retrospective and prospective data from baseline enrollment. To aid in establishing this group therapy methodology as a "promising" evidence-based intervention within a population of youths with T1DM and their families. The specific aim of this project is to enroll patients and their families into either a treatment group or a wait list control group to receive the group intervention to determine the impact of this peer and family-based group on improving adjustment, coping, and functioning within diabetes.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

A total sample size of approximately 40 youth participants and their parents (4 x 6-10) in two waves will be recruited. More specifically, there will be a treatment group (n = 6-10) and a wait list control group (n = 6-10) who participate in the first wave and another treatment group (n = 6-10) and wait list control group (n = 6-10) in the second wave. This number was chosen on the basis of including an adequate number of participants to appropriately demonstrate the effectiveness of the protocol within a clinical setting, the recommendations to conduct group therapy in cohorts of 6-10 to be the most effective clinically, and the pragmatics of participant availability based on the referral rates from the Diabetes Clinic in the past for mental health treatment. In addition, having 6-10 participants will allow for some participant attrition without impacting the effectiveness of the group therapy.

All families with an eligible participant, an adolescent between the ages of 13-17 years old with T1DM who is seen at the Children's Hospital of Wisconsin Diabetes clinic, will be recruited by diabetes providers and study researchers in the Diabetes Clinics and education classes, and from referrals to the Child and Adolescent Psychiatry and Behavioral Medicine Center Clinic. They will be given a flyer describing the study. Families will contact the intake coordinators at the Child and Adolescent Psychiatry and Behavioral Medicine Center to receive a phone intake and be screened for appropriateness of their participation in the group therapy. An insurance verification will also be completed to determine insurance coverage for participating in the group. If a family is not eligible or declines to participate in the group therapy research, they will be referred for individual therapy. For those participants who do qualify and agree verbally to participate, plans will be made for the family to participate in an intake session. At that initial intake visit, if they remain interested in participating in this study, they will be randomly assigned to the treatment group or the WLC group per the CONSORT Guidelines (Moher et al., 2001). Once they have arrived for their intake appointment in the Child and Adolescent Psychiatry and Behavioral Medicine Center, the parents and adolescents will be asked to give informed consent/assent for both the clinical and research aspects of the group therapy. They will then complete the questionnaires before their intake session. In addition, participants will be recruited through an advertisement in the Children's Hospital of Wisconsin diabetes newsletters/mailings as well as postings of the advertisement flyer and recruitment in the Diabetes Clinic.

Following parental consent and adolescent assent, the parents will complete standardized measures of general demographic information, general psychosocial functioning (e.g., quality of life, emotional and behavioral functioning of their child, parent stress, health-related family impact), and diabetes-related functioning (e.g., adherence, readiness to change behaviors, responsibility, health-related quality of life, health satisfaction). The adolescents will be asked to complete measures of general demographic information, general psychosocial functioning (e.g., quality of life, and emotional and behavioral functioning), and diabetes-related functioning (e.g., adherence, readiness to change behaviors, responsibility, health-related quality of life). For the treatment group, these measures will be given again at post-treatment and then at 4 months after baseline. For the WLC group, these measures will be given again at the initiation of group therapy, post-treatment, and 4 months after starting group treatment. (Please see attached schedule of assessments for reference). The length of time to complete these questionnaires is estimated to be around 45 minutes.

In addition to the self-report measures, each participant's medical record will be reviewed for information for the 6 months prior to baseline and the 6 months after the start of group therapy to obtain height, weight Tanner scores, hospital admissions related to diabetes, ER visits related to T1DM, outpatient diabetes clinic visits, severity of diabetes ketoacidosis (DKA) admissions through pH and HCO3 mEq/L lab work, Hemoglobin A1c levels, categorical ratings of diabetes status, and absentee rates at school from the outpatient clinic notes during the participation time period. The duration and type of diabetes reported by parents will be verified during the medical record review. We will track inpatient and outpatient hospital charges for diabetes that occur in the CHW system during the participation time frame.

Participants will be treated as outpatient clinic patients and will be responsible for all costs associated with care, including group therapy charges. Funds are not available for payment of diabetes self-management education (DSME) fees, clinic fees, lab fees, hospitalization or reimbursement of participants. Any medical or mental health costs outside of the clinical and research materials (e.g., surveys, copies, and supplies for group therapy) during the intervention will be the responsibility of the participant's family or third party insurer.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Wisconsin
      • Milwaukee, Wisconsin, United States, 53201
        • Children's Hospital of Wisconsin Child and Adolescent Psychiatry and Behavioral Medicine Center and the Diabetes Clinic

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

13 years to 17 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients who have been referred for outpatient therapy services will be included if they have Type 1 Diabetes and are 13-17 years of age.

Exclusion Criteria:

  • Potential participants will be excluded if they have the following co-existing diagnoses: mental retardation, pervasive developmental disorders, substance abuse, eating disorders, psychosis, other acute psychiatric or medical needs, such as suicidality.
  • Potential participants will be excluded if they are not fluent in the English language.
  • If a family is not eligible or declines to participate in the group therapy research, they will be referred for individual therapy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Other: Wait List Control
Patients and their families will be enrolled into either a treatment group or a wait list control (WLC) group to receive the group therapy intervention.
Behavioral: Group Therapy
Self-management Group Protocol: The parent sessions will be structured by general topic area, but teaching of clinical and behavioral information will be derived from questions and problems posed by the group in order to actively meet the needs and concerns of participants. The parent sessions will be an interactive process of eliciting concerns and questions, presenting information to address those questions, and following up with a discussion to review concerns and strategies to address the behavioral aspects of the issues. The child sessions will be activity focused, with hands-on opportunities to practice the skills being taught.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Enroll patients and their families into either a treatment group or a wait list control (WLC) group to determine the impact of a peer and family-based group intervention on improving adjustment, coping, and functioning among adolescents with diabetes.
Time Frame: Baseline, end of treatment, 4 months post-treatment, and 6 months post treatment
Baseline, end of treatment, 4 months post-treatment, and 6 months post treatment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Time Frame
Cost-effectiveness will be demonstrated through decreased health care utilization (e.g., emergency room visits, extra outpatient visits, and inpatient hospitalizations).
Time Frame: 6 months prior to initiating treatment and 6 months after initiating treatment
6 months prior to initiating treatment and 6 months after initiating treatment
Diabetes-related medical improvements from baseline to post-treatment and maintained at 4 months and 6 months post-treatment.
Time Frame: baseline, post-treatment, 4 months and 6 months post-treatment.
baseline, post-treatment, 4 months and 6 months post-treatment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Children's Hospital and Health System Foundation, Wisconsin

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Jessica C Kichler, Ph.D., Children's Hospital and Health System Foundation, Wisconsin

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 1, 2008

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 1, 2010

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2010

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 14, 2008

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 14, 2008

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 25, 2008

Study Record Updates

Last Update Posted (Estimate)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 17, 2011

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 16, 2011

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • GTP1

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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