Type 1 Doing Well: Pilot feasibility and acceptability study of a strengths-based mHealth app for parents of adolescents with type 1 diabetes

Authors: HILLIARD, MARISA - Baylor College Of Medicine; CAO, VIENA - Baylor College Of Medicine; ESHTEHARDI, SAHAR - University Of Houston; MINARD, CHARLES - Baylor College Of Medicine; SABER, RANA - Northwestern University; Thompson, Deborah - Debbe; KARAVITI, LEFKOTHEA - Baylor College Of Medicine; ANDERSON, BARBARA - Baylor College Of Medicine

Submitted to: Diabetes Technology & Therapeutics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/21/2020
Publication Date: 5/7/2020
Citation: Hilliard, M., Cao, V.T., Eshtehardi, S.S., Minard, C.G., Saber, R., Thompson, D.J., Karaviti, L.P., Anderson, B. 2020. Type 1 Doing Well: Pilot feasibility and acceptability study of a strengths-based mHealth app for parents of adolescents with type 1 diabetes. Diabetes Technology & Therapeutics. https://doi.org/10.1089/dia.2020.0048.
DOI: https://doi.org/10.1089/dia.2020.0048

Interpretive Summary: Parent/adolescent communication related to diabetes management in families with an adolescent who has type 1 diabetes can be challenging. We developed a mobile application (Type 1 Doing Well app) which aimed to promote supportive family diabetes management by helping parents recognize and reinforce teens' positive diabetes-related behaviors ("strengths"). Parents used the app at least once a day on most days. Acceptability of the app with parents was high. Therefore, feasibility was established. The Type 1 Doing Well app was feasible to deliver and highly acceptable and engaging for parents of adolescents with type 1 diabetes. It may have a larger impact on behavioral or clinical outcomes as part of a multicomponent intervention package.

Technical Abstract: We evaluated the feasibility and acceptability of a pilot behavioral intervention delivered to parents of adolescents with type 1 diabetes (T1D) via a mobile-friendly web app. The Type 1 Doing Well app aimed to promote supportive family diabetes management by helping parents recognize and reinforce teens' positive diabetes-related behaviors ("strengths"). Parents (n=80, 74% recruitment) of adolescents (age range=12-17 years, M=15.3+/-1.5 years, 59% female, 56% insulin pump, M HbA1c=9.0+/-2.1%) were randomized 2:1 to intervention or control (i.e., usual medical care with or without app) for 3-4 months between diabetes appointments. The app prompted parents daily to track adolescents' strengths and generated weekly summaries of their teen's top strengths. Parents could access a library of text messages to praise their teens. Exploratory pre-post data included questionnaires (98% completed) and HbA1c. Parents used the app for M=106.1+/-37.1 days, logging in =once/day on 80% of days. 91% of parents used the app >=2 days/week on average. Parents viewed M=5.6+/-4.7 weekly summaries and "favorited" 15 praise texts in the library. App acceptability ratings (7-point scale) were high: Satisfaction 5.0+/-1.5, Usefulness 4.8+/-1.5, Ease of Use 6.2+/-0.8, Ease of Learning 6.5+/-0.8. Parents (n=48) and adolescents (n=47) gave positive feedback and suggestions via qualitative interviews. There were no significant between-group differences for change in exploratory outcomes (HbA1c, questionnaires). Type 1 Doing Well was feasible to deliver and highly acceptable and engaging for parents of adolescents with T1D. It may have a larger impact on behavioral or clinical outcomes as part of a multicomponent intervention protocol.