Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol

Abstract Background Self-regulation (SR), or the capacity to control one’s thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition...

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Main Authors: Alison L. Miller, Sharon L. Lo, Dana Albright, Joyce M. Lee, Christine M. Hunter, Katherine W. Bauer, Rosalind King, Katy M. Clark, Kiren Chaudhry, Niko Kaciroti, Benjamin Katz, Emily M. Fredericks
Format: Article
Language:English
Published: BMC 2020-03-01
Series:BMC Pediatrics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12887-020-2012-7
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author Alison L. Miller
Sharon L. Lo
Dana Albright
Joyce M. Lee
Christine M. Hunter
Katherine W. Bauer
Rosalind King
Katy M. Clark
Kiren Chaudhry
Niko Kaciroti
Benjamin Katz
Emily M. Fredericks
author_facet Alison L. Miller
Sharon L. Lo
Dana Albright
Joyce M. Lee
Christine M. Hunter
Katherine W. Bauer
Rosalind King
Katy M. Clark
Kiren Chaudhry
Niko Kaciroti
Benjamin Katz
Emily M. Fredericks
author_sort Alison L. Miller
collection DOAJ
description Abstract Background Self-regulation (SR), or the capacity to control one’s thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity and thus a compelling period for intervention. Promoting SR among adolescents with T1D may thus be a novel method to improve treatment regimen adherence. The current study tests a behavioral intervention to enhance SR among adolescents with T1D. SR and T1D medical regimen adherence will be examined as primary and secondary outcomes, respectively. Methods We will use a randomized control trial design to test the impact of a behavioral intervention on three SR targets: Executive Functioning (EF), Emotion Regulation (ER), and Future Orientation (FO); and T1D medical regimen adherence. Adolescents with T1D (n = 94) will be recruited from pediatric endocrinology clinics and randomly assigned to treatment or control group. The behavioral intervention consists of working memory training (to enhance EF), biofeedback and relaxation training (to enhance ER), and episodic future thinking training (to enhance FO) across an 8-week period. SR and treatment regimen adherence will be assessed at pre- and post-test using multiple methods (behavioral tasks, diabetes device downloads, self- and parent-report). We will use an intent-to-treat framework using generalized linear mixed models to test our hypotheses that: 1) the treatment group will demonstrate greater improvements in SR than the control group, and 2) the treatment group will demonstrate better treatment regimen adherence outcomes than the control group. Discussion If successful, SR-focused behavioral interventions could improve health outcomes among adolescents with T1D and have transdiagnostic implications across multiple chronic conditions requiring treatment regimen adherence. Trial registration ClinicalTrials.gov: NCT03688919 ; registered September 28, 2018.
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spelling doaj.art-a9211b6e8fc64dd7a84c023c2822e7a12022-12-21T20:15:28ZengBMCBMC Pediatrics1471-24312020-03-0120111010.1186/s12887-020-2012-7Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocolAlison L. Miller0Sharon L. Lo1Dana Albright2Joyce M. Lee3Christine M. Hunter4Katherine W. Bauer5Rosalind King6Katy M. Clark7Kiren Chaudhry8Niko Kaciroti9Benjamin Katz10Emily M. Fredericks11Department of Health Behavior and Health Education, University of Michigan School of Public HealthDepartment of Health Behavior and Health Education, University of Michigan School of Public HealthDepartment of Pediatrics, University of Michigan Medical SchoolDepartment of Pediatrics, University of Michigan Medical SchoolOffice of Behavioral and Social Sciences Research, National Institutes of HealthCenter for Human Growth and Development, University of MichiganEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthDepartment of Health Behavior and Health Education, University of Michigan School of Public HealthDepartment of Health Behavior and Health Education, University of Michigan School of Public HealthDepartment of Pediatrics, University of Michigan Medical SchoolDepartment of Human Development and Family ScienceDepartment of Pediatrics, University of Michigan Medical SchoolAbstract Background Self-regulation (SR), or the capacity to control one’s thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity and thus a compelling period for intervention. Promoting SR among adolescents with T1D may thus be a novel method to improve treatment regimen adherence. The current study tests a behavioral intervention to enhance SR among adolescents with T1D. SR and T1D medical regimen adherence will be examined as primary and secondary outcomes, respectively. Methods We will use a randomized control trial design to test the impact of a behavioral intervention on three SR targets: Executive Functioning (EF), Emotion Regulation (ER), and Future Orientation (FO); and T1D medical regimen adherence. Adolescents with T1D (n = 94) will be recruited from pediatric endocrinology clinics and randomly assigned to treatment or control group. The behavioral intervention consists of working memory training (to enhance EF), biofeedback and relaxation training (to enhance ER), and episodic future thinking training (to enhance FO) across an 8-week period. SR and treatment regimen adherence will be assessed at pre- and post-test using multiple methods (behavioral tasks, diabetes device downloads, self- and parent-report). We will use an intent-to-treat framework using generalized linear mixed models to test our hypotheses that: 1) the treatment group will demonstrate greater improvements in SR than the control group, and 2) the treatment group will demonstrate better treatment regimen adherence outcomes than the control group. Discussion If successful, SR-focused behavioral interventions could improve health outcomes among adolescents with T1D and have transdiagnostic implications across multiple chronic conditions requiring treatment regimen adherence. Trial registration ClinicalTrials.gov: NCT03688919 ; registered September 28, 2018.http://link.springer.com/article/10.1186/s12887-020-2012-7Self-regulationBehavioral interventionMedical regimen adherenceType 1 diabetesAdolescence
spellingShingle Alison L. Miller
Sharon L. Lo
Dana Albright
Joyce M. Lee
Christine M. Hunter
Katherine W. Bauer
Rosalind King
Katy M. Clark
Kiren Chaudhry
Niko Kaciroti
Benjamin Katz
Emily M. Fredericks
Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol
BMC Pediatrics
Self-regulation
Behavioral intervention
Medical regimen adherence
Type 1 diabetes
Adolescence
title Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol
title_full Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol
title_fullStr Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol
title_full_unstemmed Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol
title_short Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol
title_sort adolescent interventions to manage self regulation in type 1 diabetes aims t1d randomized control trial study protocol
topic Self-regulation
Behavioral intervention
Medical regimen adherence
Type 1 diabetes
Adolescence
url http://link.springer.com/article/10.1186/s12887-020-2012-7
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