Telehealth Behavioral Self-Management Intervention For Teens with Type 2 Diabetes

Nearly 25% of children have a chronic condition requiring ongoing treatment and families have significant day-to-day responsibility for treatment regimens. Yet many regimens are time consuming intrusive and result in high burden to families. Indeed nonadherence to treatment regimens for pediatric chronic conditions is common (nonadherence occurs among > 50% of youth) and contributes to higher rates of morbidity mortality and costly healthcare utilization. Adolescence is a period of vulnerability for poor treatment adherence and families of racial/ethnic minority youth namely African Americans and Hispanics are more likely to experience nonadherence. Nonadherence thereby contributes to the pervasive and costly disparities in health outcomes for minority youth. Fortunately behavioral self-management interventions have successfully improved adherence and health outcomes of minority youth with some chronic conditions that disproportionately occur in these groups (e.g. asthma HIV). However the reach of most interventions to minority youth with chronic conditions is limited because they almost exclusively have been delivered in clinic or school settings. Minority families disproportionately face barriers to receiving interventions in clinic settings such as difficulties with transportation and inflexible work environments that result in poor clinic attendance. Furthermore delivery in school settings is not an efficient option to address adherence among chronic conditions that occur in a very low proportion of children in a given school (e.g. diabetes). Alternative modes of intervention delivery are needed to maximize reach to minority children with chronic conditions. The purpose of this study is to address this need by creating and testing a home telehealth videoconferencing behavioral self-management intervention among youth (10-15 years) with type 2 diabetes (T2D) and their families. T2D disproportionately occurs among racial/ethnic minority youth (~80%). This study is to serve as a model for implementing telehealth videoconferencing for delivering self-management interventions for other chronic conditions that disproportionately affect minority youth (e.g. HIV). The adapted intervention we will create Family Teamwork-Telehealth Delivery has strong potential to improve health outcomes of youth with diabetes by allowing access to an intervention in the convenience of their own home using videoconferencing which is a familiar mode of communication among adolescents. The proposed study is relevant to MCHB Strategic Research Issue focused on services to eliminate health disparities among minority youth. To inform the design of the new Family Teamwork-Telehealth Delivery (FT-T) intervention we will apply participatory approaches to adapt intervention components for delivery via telehealth videoconferencing. The study will occur in Houston TX where ~80% of youth with T2D are African American or Hispanic. In the design phase (Aim 1) a Family Advisory Board of adolescents and parents will inform adaptation for telehealth-delivery format. In the pilot phase (Aim 2 years 3-4) we will test the feasibility parent and child satisfaction and preliminary clinical outcomes of FT-T using a randomized pilot trial design (N= 45); families of 10-15 year old children with T2D will be randomized to the FT-T intervention or to usual diabetes care. Content Terms: Telehealth Chronic Illness Physical Activity Mental Health and Wellbeing Age Ranges: Adolescence Middle Childhood Targeted Populations: African American/Hispanic Hispanic/Latino Low Income Special Health Care Needs EHB Application Number: 170980 Grant Number: N/A Tracking Number: GRANT12970919 Page Number: 5 Funding Opportunity Number: HRSA-20-056 Received Date: 11/12/2019 7:01:47 P