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Pilot Study: Intensive Education in a Residential Camp Setting for Families of Young Children With Type 1 Diabetes (TotCamp)

18 preschool aged children and their families will attend structured, multidisciplinary, family-centered intensive education sessions over a 3-day weekend in a residential camp setting to address the unique challenges of managing type 1 diabetes mellitus in young children. A second 'booster' session, will be conducted 6 months later.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

We propose to deliver a structured multidisciplinary family-centered intervention over a 3-day weekend, with a second similar "booster" session 6 months later. The intervention will be based at our regional diabetes camp, Camp Sweeney. The proposed camp encounters aim to provide:

  • An opportunity for intensive education beyond that achievable in a single class, and without the unfavorable impacts of multiple weekday classes on family and work time.
  • Varied educational modalities including didactic sessions, practical demonstrations and role playing.
  • Close observation of each child throughout the day and night by experienced diabetes counselors and medical staff to identify and help correct maladaptive family behaviors.
  • A safe environment where parents can participate in group therapy sessions without child care worries.
  • An opportunity for age-appropriate child-centered educational and therapeutic activities.
  • An opportunity for families to form mutually-supportive friendships.
  • Fun weekends away where the parents have help caring for their diabetic children.

We will conduct this pilot study, which will enroll 18 preschool children age 3-5.5 years, with the goal of obtaining preliminary results for 15 subjects.

The primary outcome, to be determined approximately one month before and after each of the two camp sessions, is improvement in Hemoglobin A1c (HbA1c). This outcome will be compared with that of historical controls.

Exploratory Hypotheses:

Compared with pretreatment baseline and historical controls, subjects attending two 3-day sessions at a family diabetes camp will improve:

  • HbA1c 3 months after the first camp session
  • Hypoglycemia frequency, as measured by continuous glucose monitoring
  • Medical system utilization, as measured by telephone call frequency and also by emergency room visits and hospitalizations
  • Behavioral/QoL assessments, including the parents of young children version of the hypoglycemia fear survey (HFS-P-YC), the Behavioral Pediatrics Feeding Assessment Scale (BPFAS), and the general and diabetes modules of the PedsQL.
  • Diabetes knowledge, assessed by questionnaire
  • Development of friendships between subject families, assessed by questionnaire

Type d'étude

Interventionnel

Inscription (Réel)

18

Phase

  • N'est pas applicable

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

2 ans à 5 ans (Enfant)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Age 3-5.5 years old (+/- 2 months) at the date of first camp session they are eligible to join.
  • Child and Parents fluent in either English or Spanish.
  • Type 1 diabetes mellitus diagnosed for at least 10 months previous to date of first camp they are eligible to join.
  • Taking insulin
  • Custodial parent or guardian (preferable both parents or guardians) willing to attend both session of camp and the activities scheduled for them.
  • Parent or guardian must sign consent before any study procedures are performed.

Exclusion Criteria:

  • Neonatal diabetes (diagnosis in the first 3 months of life) or documented MODY; i.e., a likely genetic form of diabetes rather than an autoimmune etiology.
  • Post-surgical diabetes (e.g., pancreatectomy for congenital hyperinsulinism). Such patients often cannot secrete glucagon, leading to a particularly severe inability to defend against hypoglycemia.
  • Other severe chronic disease (e.g., cancer, cystic fibrosis) which in the judgment of the investigator is likely to significantly affect glycemic control.
  • Patients cannot be taking systemic corticosteroids at enrollment because of adverse effects on glycemic control, but we will not disqualify subjects who require such therapy during the study. Inhaled or topical corticosteroids are permissible.
  • Patients with hypothyroidism or hyperthyroidism must be clinically euthyroid and have free T4 and TSH within age-appropriate reference ranges at last medically indicated testing. Patients with out of range values may be retested after medication dose adjustment.
  • Developmental delay or behavioral disorder in the patient of sufficient severity, in the judgment of the investigator, to interfere with group activities.
  • Medical or psychiatric disorder in a parent of sufficient severity, in the judgment of the investigator, to interfere with group activities.
  • Celiac disease is not an exclusion criterion.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Soins de soutien
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Autre: Intensive Education
Attendance of 2 intensive education sessions
Participants will attend a 3 day family-centered, multidisciplinary, intensive education session at our regional diabetes camp, Camp Sweeney. A second 'booster' session will be conducted 6 months later.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in Hemoglobin A1c one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
As compared to historical controls
One month pre-camp, one month post-camp
Change in Hemoglobin A1c one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
As compared to historical controls
One month pre-camp, one month post-camp

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in Hypoglycemia frequency one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
As measured by continuous glucose monitoring, and quantitated as area under the curve for blood glucoses <70 mg/dL.
One month pre-camp, one month post-camp
Change in Hypoglycemia frequency one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
As measured by continuous glucose monitoring, and quantitated as area under the curve for blood glucoses <70 mg/dL.
One month pre-camp, one month post-camp
Medical system utilization ( emergency room visits, hospitalizations related to T1DM)
Délai: Duration of participation in study, expected to be 10 months
Composite measure. As compared to historical controls.
Duration of participation in study, expected to be 10 months
Change in PedsQL Family Impact Module one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
Parent report
One month pre-camp, one month post-camp
Change in PedsQL Family Impact Module one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
Parent report
One month pre-camp, one month post-camp
Change in PedsQL Pediatric Quality of Life Inventory one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
Parent report for Toddlers, Parent report for Young Children, Young Child Report
One month pre-camp, one month post-camp
Change in PedsQL Pediatric Quality of Life Inventory one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
Parent report for Toddlers, Parent report for Young Children, Young Child Report
One month pre-camp, one month post-camp
Change in PedsQL Diabetes Module one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
Parent report for Toddlers, Parent report for Young Children, Young Child Report
One month pre-camp, one month post-camp
Change in PedsQL Diabetes Module one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
Parent report for Toddlers, Parent report for Young Children, Young Child Report
One month pre-camp, one month post-camp
Change in Hypoglycemia Fear Survey one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
Parents of young children version
One month pre-camp, one month post-camp
Change in Hypoglycemia Fear Survey one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
Parents of young children version
One month pre-camp, one month post-camp
Change in Behavioral Pediatrics Feeding Assessment one month pre-camp to one month post-camp Session 1
Délai: One month pre-camp, one month post-camp
Behavior section
One month pre-camp, one month post-camp
Change in Behavioral Pediatrics Feeding Assessment one month pre-camp to one month post-camp Session 2
Délai: One month pre-camp, one month post-camp
Behavior section
One month pre-camp, one month post-camp

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Perrin White, MD, UT Southwestern Medical Center

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 juillet 2014

Achèvement primaire (Réel)

1 août 2016

Achèvement de l'étude (Réel)

1 janvier 2017

Dates d'inscription aux études

Première soumission

10 mars 2015

Première soumission répondant aux critères de contrôle qualité

28 avril 2015

Première publication (Estimation)

4 mai 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

23 juin 2017

Dernière mise à jour soumise répondant aux critères de contrôle qualité

21 juin 2017

Dernière vérification

1 juin 2017

Plus d'information

Termes liés à cette étude

Plan pour les données individuelles des participants (IPD)

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