Authors
Stanger C, Lansing AH, Scherer EA, Budney AJ, Christiano AS, Casella SJ
Purpose
Researchers compared effects of web-delivered counseling, working memory training, and incentives (WebRx) delivered over 6 months to usual care (UC) for adolescents with poorly controlled type 1 diabetes and their parents on blood glucose monitoring behavior.
Methods
Adolescents with type 1 diabetes and elevated blood glucose readings (HbA1c ≥ 8%) and at least one of their parents were randomized to receive WebRx or UC. WebRx targeted adolescent glucose self-monitoring, executive functioning, working memory, and parent monitoring of adolescent glucose checking behavior. Adolescents and parents earned incentives for frequent glucose monitoring and daily parental reports about adolescent glucose checks, respectively. Adolescents completed assessments of glucose monitoring, working memory, and inhibitory control. Parents completed assessments of family conflict and whether they reviewed of adolescent glucose monitoring. Assessments were administered at baseline, 6-, and 12-months.
Findings
- Most participating parents and adolescents (93%) completed at least 12/15 counseling sessions, and most adolescents (83%) completed at least 20/25 working memory training sessions.
- There were significant between-group differences in glucose monitoring frequency, family conflict, parent monitoring frequency, inhibitory control, and working memory favoring WebRX at 6-month follow up.
- WebRX group differences in glucose monitoring, family conflict, and working memory were maintained at 12 months.
Relevance
- WebRx may promote adolescent and parent blood glucose monitoring behavior better than UC.
- Incentives for adolescents and parents may have increased adherence to glucose monitoring and WebRX, but also increased cost.
- Future research exploring how individual components of WebRx impact intervention mechanisms could help identify effective components.