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Title: Strengths-based behavioral intervention for parents of adolescents with type 1 diabetes using an mHealth app (Type 1 Doing Well): Protocol for a pilot randomized controlled trial

Author
item HILLIARD, MARISA - Baylor College Of Medicine
item ESHTEHARDI, SAHAR - Baylor College Of Medicine
item MINARD, CHARLES - Baylor College Of Medicine
item SABER, RANA - Northwestern University
item Thompson, Deborah - Debbe
item KARAVITI, LEFKOTHEA - Baylor College Of Medicine
item ROJAS, YULIANA - Baylor College Of Medicine
item ANDERSON, BARBARA - Baylor College Of Medicine

Submitted to: JMIR Research Protocols
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/3/2018
Publication Date: 3/13/2018
Citation: Hilliard, M.E., Eshtehardi, S.S., Minard, C.G., Saber, R., Thompson, D.J., Karaviti, L., Rojas, Y., Anderson, B.J. 2018. Strengths-based behavioral intervention for parents of adolescents with type 1 diabetes using an mHealth app (Type 1 Doing Well): Protocol for a pilot randomized controlled trial. JMIR Research Protocols. 7(3):e77. http://dx.doi.org/10.2196/resprot.9147.

Interpretive Summary: In their concern for their adolescent with type 1 diabetes, parents often focus on what the adolescent may not be doing well. This is a concern because it could influence both the parent-adolescent relationship and the adolescent's motivation to engage in diabetes self-management. An app was developed for parents to encourage them to focus on what their adolescent was doing well. This approach has the potential to reduce risk of family conflict and enhance parent/adolescent teamwork surround diabetes management tasks which has the potential to improve diabetes outcomes.

Technical Abstract: Supportive parent involvement for adolescents' type 1 diabetes (T1D) self-management promotes optimal diabetes outcomes. However, family conflict is common and can interfere with collaborative family teamwork. Few interventions have used explicitly strengths-based approaches to help reinforce desired management behaviors and promote positive family interactions around diabetes care. The aim of this protocol was to describe the development of a new, strengths-based behavioral intervention for parents of adolescents with T1D delivered via a mobile-friendly Web app called Type 1 Doing Well. Ten adolescent-parent dyads and 5 diabetes care providers participated in a series of qualitative interviews to inform the design of the app. The 3- to 4-month pilot intervention will involve 82 parents receiving daily prompts to use the app, in which they will mark the diabetes-related strength behaviors (ie, positive attitudes or behaviors related to living with or managing T1D) their teen engaged in that day. Parents will also receive training on how to observe diabetes strengths and how to offer teen-friendly praise via the app. Each week, the app will generate a summary of the teen's most frequent strengths from the previous week based on parent reports, and parents will be encouraged to praise their teen either in person or from a library of reinforcing text messages (short message service, SMS). The major outcomes of this pilot study will include intervention feasibility and satisfaction data. Clinical and behavioral outcomes will include glycemic control, regimen adherence, family relationships and conflict, diabetes burden, and health-related quality of life. This strengths-based, mobile health (mHealth) intervention aims to help parents increase their awareness of and efforts to support their adolescents' engagement in positive diabetes-related behaviors. If efficacious, this intervention has the potential to reduce the risk of family conflict, enhance collaborative family teamwork, and ultimately improve diabetes outcomes.