A systematic review of parent/peer-based group interventions for adolescents with type 1 diabetes: interventions based on theoretical/therapeutic frameworks

Kalsoom Akhter, Triece Turnbull, David Simmons

Abstract


Objective: Although interventions which provide psychosocial support can have a positive impact on diabetes self-care, the impact of family/peer- and theory-based interventions has not yet been clearly identified. This systematic review investigates the randomised controlled trials (RCTs) employing family/peer-based interventions (based on theoretical/ therapeutic frameworks) which aim to improve adolescents’ glycaemic control, psychosocial and/or behavioural functioning.

Methods: The Cochrane Library, database of systematic reviews, database of abstracts of reviews of effectiveness and Health Technology Assessment database were searched (from start date until February 2016) for any previously conducted systematic reviews. Seventeen RCTs/interventions were included. The literature was also identified by contacting the leading researchers. Glycaemic control was measured by HbA1c and psychosocial functioning by measures of self-care, knowledge and communication, collaboration/teamwork, quality of life, problem solving, social functioning and family functioning. Only those interventions which reported the use of theories/therapies to manage type 1 diabetes and other psychosocial issues among adolescents (aged 12–17) were included in the present review. Data summarising the key features of the interventions was extracted from each article. Where possible, the effect sizes were calculated.

Results: The effect sizes could be computed for HbA1c in six of the 17 interventions. The overall outcomes indicated that interventions including parents have a small to large effect size on a variety of diabetes management and psychosocial outcomes. This review identified interventions, mostly including parents and rarely including peers.

Conclusion: The results of this systematic review demonstrate that multicomponent interventions may be more successful for adolescents than ones that just focus on one aspect. Effectiveness is also greater if they demonstrate inter-relatedness with the various aspects of diabetes management. Short-term behavioural approach-based interventions promote improvements in parent/adolescent relationships. Outreach home-based interventions could be a more accessible alternative for intervening with families than office/hospital-based interventions. This approach may also be more acceptable to adolescents and their families. There is a need to develop evaluated interventions for adolescents involving parents. Development should involve stakeholders (ie, adolescents, their families and healthcare professionals) to co-design potentially cost-effective and feasible interventions in the context of NHS diabetes services.


Keywords


family/peer-based interventions, psychosocial and behaviouraltheories/therapies, diabetes and psychosocial functioning, type 1 diabetes, adolescents

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References


Glasgow RE, Fisher EB, Anderson BJ, et al. Behavioural science in diabetes: contributions and opportunities. Diabetes Care1999;22:832–43. https://doi.org/10.2337/diacare.22.5.832

Pendley JS, Kasmen LJ, Miller DL, et al. Peer and family support in children and adolescents with T1D. J Pediatr Psychol 2002;27:429–38. https://doi.org/10.1093/jpepsy/27.5.429

Diabetes Control and Complications Trial. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. N Engl J Med 1993;329:977–86. https://doi.org/10.1056/NEJM199309303291401

Diabetes Control and Complications Trial. Effect of intensive diabetes treatment on the development of long-term complications in adolescents with insulin-dependent diabetes mellitus. J Pediatr 1994;125:177–88. https://doi.org/10.1016/S0022-3476(94)70190-3

Delamater AM. Psychological care of children and adolescents with diabetes. Pediatr Diabetes 2009;10:175–84. http://dx.doi.org/10.1111/j.1399-5448.2009.00580.x

Anderson BJ, Brackett BA, Joyce H, et al. An office-based intervention to maintain parent–adolescent teamwork in diabetes management. Diabetes Care1999;22:713–21. https://doi.org/10.2337/diacare.22.5.713

Laffel LM, Vangsness L, Connell A, et al. Impact of ambulatory, family-focused teamwork intervention on glycaemic control in youth with T1D. J Pediatr 2003;142:409–16. http://dx.doi.org/10.1067/mpd.2003.138

Berg CA, Wiebe DJ, Beveridge RM, et al. Mother child appraisal involvement in coping with diabetes stressors and emotional adjustment. J Pediatr Psychol 2007;32:995–1005. http://dx.doi.org/10.1093/jpepsy/jsm043

Cameron F, Skinner T, De Beaufort C, et al. Hvidoere Study Group on Childhood Diabetes. Are family factors universally related to metabolic outcomes in adolescents with T1D? Diabet Med 2008;25:463–8. https://doi.org/10.1111/j.1464-5491.2008.02399.x

Schilling LS, Knafl KA, Grey M. Changing patterns of self-management in youth with type I diabetes. J Pediatr Nurs 2006;21:412–24. http://dx.doi.org/10.1016/j.pedn.2006.01.034

Wysocki T. Associations among teen-parent relationships, metabolic control, and adjustment to diabetes in adolescents. J Pediatr Psychol 1993;18:441–52. https://doi.org/10.1093/jpepsy/18.4.441

Wysocki T, Taylor A, Hough BS, et al. Deviation from developmentally appropriate self-care autonomy: association with diabetes outcomes. Diabetes Care 1996;19:119–25. https://doi.org/10.2337/diacare.19.2.119

Greco P, Greca AM, Auslander W, et al. Family and peer support of diabetes care among adolescents. Diabetes 1991;40:537A.

La Greca AM, Auslander WF, Greco P, et al. I get by with a little help from my family and friends: adolescents' support for diabetes care. J Pediatr Psychol 1995;20:449–76. https://doi.org/10.1093/jpepsy/20.4.449

Greco P, Pendley JS, McDonell K, Reeves G. A peer group intervention for adolescents with T1D and their best friends. J Pediatr Psychol 2001;26:485–90. https://doi.org/10.1093/jpepsy/26.8.485

Fuligni AJ, Eccles JS, Barber BL, Clements P. Early adolescent peer orientation and adjustment during high school. Devel Psychol 2001;37:28–36. https://doi.org/10.1037/0012-1649.37.1.28

Harvey JN. Health beliefs and health outcomes. In: Martin LR, DiMatteo MR, eds.The Oxford Handbook of Health Communication, Behaviour Change and Treatment Adherence. New York: Oxford University Press, 2013:177–92. https://doi.org/10.1093/oxfordhb/9780199795833.013.006

Diefenebach MA, Leventhal H. The common-sense model of illness representation: theoretical and practical considerations. J Social Distress Homeless 1996;5:11–38. https://doi.org/10.1007/BF02090456

Leventhal H, Hudson S, Robitaille C. Health, coping, and well-being perspectives from social comparison theory. In: Buunk BP, Gibbons FX, eds. Social Comparison and Health: A Process Model. Mahweh, NJ: Lawrence Erlbaum Associates, 1997.

Browning KK, Wewers ME, Ferketich AK, Otterson GA, Reynolds NR. The Self-regulation Model of Illness applied to smoking behaviour in lung cancer. Cancer Nursing 2009;32:E15–25. https://doi.org/10.1097/NCC.0b013e3181a0238f

Henderson DJ. Consciousness-rising as a feminist nursing action. Promise and practice, present and future. In: Thorne SE, Hayes VE, eds. Nursing Praxis: Knowledge and Action. London: Sage Publications, 1997.

Laverack G. Empowerment and Professional Practice. Basingstoke: Palgrave Macmillan, 2005.

Gibson CH. The process of empowerment in mothers of chronically ill children. J Advan Nursing 1995;21:1201–10. https://doi.org/10.1046/j.1365-2648.1995.21061201.x

Naidoo J, Wills J. Health Promotion: Foundations for Practice. London: Elsevier Health Sciences, 2000.

Craig PM, Lindsay GM. Nursing for Public Health: Population-Based Care. New York: Elsevier Health Sciences, 2000.

Anderson R, Funnell M. Compliance and adherence are dysfunctional concepts in diabetes care. Diabetes Educ 2000;26:597–604. https://doi.org/10.1177/014572170002600405

Tol A, Alhani F, Shojaeazadeh D, et al. An empowering approach to promote the quality of life and self-management among type 2 diabetic patients. J Educ Health Promot 2015;4:13. http://dx.doi.org/10.4103/2277-9531.154022

Williams BW, Kessler HA, Williams MV. Relationship among practice change, motivation, and self-efficacy. J Contin Educ Health Prof 2014; 34(Suppl 1):S5–S10.7. http://dx.doi.org/10.1002/chp.21235

Bandura A. Self-efficacy: toward a unifying theory of behaviour change. Psychol Rev 1977;84:191–215. https://doi.org/10.1037/0033-295X.84.2.191

Dehghan H, Charkazi A, Mohammad Kouchaki G, et al. General self-efficacy and diabetes management self-efficacy of diabetic patients referred to diabetes clinic of Aq Qala, North of Iran. J Diabetes Metab Disord 2017;16:8. http://dx.doi.org/10.1186/s40200-016-0285-z

Bandura A. Social cognitive theory of self-regulation. Organizational Behaviour and Human Decision Processes 1991;50:248–87. https://doi.org/10.1016/0749-5978(91)90022-L.

Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall,1986.

Yi-Frazier JP, Hilliard M, Cochrane K, Hood KK. The impact of positive psychology on diabetes outcomes: a review. Psychology 2012; 3(12A):1116–24. http://dx.doi.org/10.4236/psych.2012.312A165

Bronfenbrenner U. The Ecology of Human Development: Experiments by Design and Nature. Cambridge, MA: Harvard University Press, 1979.

Minuchin S. Families and Family Therapy. Cambridge, MA: Harvard University Press, 1974.

Haley J. Problem-Solving Therapy. 2nd edn. San Franciso: Jossey-Bass, 1987.

Henggeler SW, Sheidow AJ. Empirically supported family-based treatments for conduct disorder and delinquency in adolescents. J Marital Fam Ther 2012;38:30–58. http://dx.doi.org/10.1111/j.1752-0606.2011.00244.x

Gordon SB, Davidson N. Behavioural parent training. In: Gurman AS, Kniskern DP, eds. Handbook of Family Therapy. New York: Brunner/Mazel, 1981.

Jacobson NS, Margolin G. Marital Therapy: Strategies Based on Social Learning and Behaviour Exchange Principles. New York: Brunner/Mazel, 1979.

Patterson GR. Coercive Family Process. Eugene, OR: Castalia, 1982.

Aponte HJ, VanDeusen JM. Structural family therapy. In: Gurman AS, Kniskern DP, eds. Handbook of Family Therapy. New York: Brunner/Mazel, 1981.

Steinglass P. A systems view of family interaction and psychopathology. In: Jacob T, ed. Family Interaction and Psychopathology. New York: Plenum Press, 1987. https://doi.org/10.1007/978-1-4899-0840-7_2

Robin AL, Foster SL. Negotiating Parent-Adolescent Conflict: A Behavioural-Family System Approach. New York, London: Guilford Press, 1989.

Anderson BJ, Wolf FM, Burkhart MT, et al. Effects of a peer group intervention on metabolic control of adolescents with IDDM: randomized outpatient study. Diabetes Care 1989;12:184–8. https://doi.org/10.2337/diacare.12.3.179

Løding RN, Wold JE, Skavhaug Å. Experiences with a group intervention for adolescents with T1D and their parents. Eur Diabetes Nursing 2008;5:9–14. https://doi.org/10.1002/edn.96

Hansson K, Ryden O, Johnsson P. Parent-related family climate: a concomitant to metabolic control in juvenile IDDM. Fam Syst Med 1994;12:405–13. https://doi.org/10.1037/h0089272

Løding RN, Wold JE, Skavhaug Å, Graue M. Evaluation of peer-group support and problem-solving training in the treatment of adolescents with T1D. Eur Diabetes Nursing 2007;4:28–33. https://doi.org/10.1002/edn.73

Salamon KS, Hains AA, Fleischman KM, Davies WH, Kichler J. Improving adherence in social situations for adolescents with type 1 diabetes mellitus (T1DM): a pilot study. Primary Care Diabetes 2010;4:47–55. http://dx.doi.org/10.1016/j.pcd.2009.10.003

Harris MA, Harris BS, Mertlich D. Brief report: in-home family therapy for adolescents with poorly controlled diabetes: failure to maintain benefits at 6-month follow-up. J Pediatr Psychol 2005;30:683–8. http://dx.doi.org/10.1093/jpepsy/jsi055

Ellis DA, Naar-King S, Templin T, et al. Multisystemic therapy for adolescents with poorly controlled T1D: reduced diabetic ketoacidosis admissions and related costs over 24 months. Diabetes Care 2008;31:1746–7. http://dx.doi.org/10.2337/dc07-2094

Forsander GA, SundelinJ, Persson B. Influence of the initial management regimen and family social situation on glycaemic control and medical care in children with type 1 diabetes mellitus. Acta Paediatr 2000; 89:1462–8.

Nansel T, Ionnotti RJ, Simons-Morton BG, et al. Long-term maintenance of treatment outcomes: diabetes personal trainer intervention for youth with type 1 diabetes. Diabetes Care 2009;32:807–09. http://dx.doi.org/10.2337/dc08-1968

Philis-Tsimikas A, Fortmann A, Lleva-Ocana L, Walker C, Gallo LC. Peer-led diabetes education programs in high-risk Mexican Americans improve glycaemic control compared with standard approaches: a Project Dulce promotora randomized trial. Diabetes Care 2011;34:1926–31. http://dx.doi.org/10.2337/dc10-2081

Hampson SE, Skinner TC, Hart J, et al. Effects of educational and psychological interventions for adolescents with diabetes mellitus: a systematic review. Health Technol Assess 2001;5:1–77. https://doi.org/10.3310/hta5100

Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evid Based Nurs 2004;1:176–84. http://dx.doi.org/10.1111/j.1524-475X.2004.04006.x

Ellis DA, Naar-King S, Frey M, et al. Use of multi-systemic therapy to improve regimen adherence among adolescents with T1D in poor metabolic control: a pilot investigation. J Clin Psychol Medical Settings 2004;11:315–24. https://doi.org/10.1023/B:JOCS.0000045351.98563.4d

Ellis DA, Frey M, Naar-King S, et al. Use of multisystemic therapy to improve regimen adherence among adolescents with type 1 diabetes in chronic poor metabolic control: a randomized controlled trial. Diabetes Care 2005;28:1604–10. https://doi.org/10.2337/diacare.28.7.1604

Ellis DA, Yopp J, Templin T, et al. Family mediators and moderators of treatment outcomes among youths with poorly controlled type 1 diabetes: results from a randomized controlled trial. J Pediatr Psychol 2007;32:194–205. http://dx.doi.org/10.1093/jpepsy/jsj116

Harris MA, Freeman KA, Beers M. Family therapy for adolescents with poorly controlled diabetes: initial test of clinical significance. J Pediatr Psychol 2009;34:1097–107. http://dx.doi.org/10.1093/jpepsy/jsp009

Satin W, La Greca AM, Zigo MA, Skyler JS. Diabetes in adolescence. Effects of multifamily group intervention and parent simulation of diabetes. J Pediatr Psychol 1989;14:259–75. https://doi.org/10.1093/jpepsy/14.2.259

Nansel TR, Iannotti RJ, Liu A. Clinic-integrated behavioral intervention for families of youth with T1D: randomized clinical trial. Pediatrics 2012;129:e866–73. http://dx.doi.org/10.1542/peds.2011-2858

Kaplan RM, Chadwick MW, Schimmel LE. Social learning intervention to promote metabolic control in type I diabetes mellitus: pilot experiment results. Diabetes Care 1985;8:152–5. https://doi.org/10.2337/diacare.8.2.152

Viklund G, Ortqvist E, Wikblad K. Assessment of an empowerment education programme. A randomized study in teenagers with diabetes. Diabet Med 2007;24:550–6. http://dx.doi.org/10.1111/j.1464-5491.2007.02114.x

Wysocki T, Harris M, Greco P, et al. Social validity of support group and behaviour therapy interventions for families of adolescents with insulin-dependent diabetes mellitus. J Pediatr Psychol 1997;22:635–49. https://doi.org/10.1093/jpepsy/22.5.635

Wysocki T, Harris MA, Greco P, et al. Randomized controlled trial of behaviour therapy for families of adolescents with insulin-dependent diabetes mellitus. J Pediatr Psychol 2000;25:23–33. https://doi.org/10.1093/jpepsy/25.1.23

Wysocki T, Greco P, Harris MA, et al. Behaviour therapy for families of adolescents with diabetes: maintenance of treatment effects. Diabetes Care 2001;24:441–6. https://doi.org/10.2337/diacare.24.3.441

Wysocki T, Harris MA, Buckloh LM, et al. Effects of behavioural family systems therapy for diabetes on adolescents’ family relationships, treatment adherence, and metabolic control. J Pediatr Psychol 2006;31:928–38. http://dx.doi.org/10.1093/jpepsy/jsj098

Wysocki T, Harris MA, Buckloh LM, et al. Randomized trial of behavioural family systems therapy for diabetes: maintenance of effects on diabetes outcomes in adolescents. Diabetes Care 2007;30:555–60. http://dx.doi.org/10.2337/dc06-1613

Wysocki T, Harris MA, Buckloh LM, et al. Randomized controlled trial of behavioural family systems therapy for diabetes: maintenance and generalization of effects on parent-adolescent communication. Behav Ther 2008;39:33–46. https://doi.org/10.1016/j.beth.2007.04.001

Newton KT, Ashley A. Pilot study of a web-based intervention for adolescents with type 1 diabetes. J Telemed Telecare 2013;19:443–9. http://dx.doi.org/10.1177/1357633X13512069

Jaser SS, Patel N, Linsky R, Whittemore R. Development of a positive psychology intervention to improve adherence in adolescents with type 1 diabetes. J Pediatr Health Care 2014;28:478–85. http://dx.doi.org/10.1016/j.pedhc.2014.02.008

Kichler JC, Kaugars AS, Marik P, Nabors L, Alemzadeh R. Effectiveness of groups for adolescents with type 1 diabetes mellitus and their parents. Families System Health 2013;31:280–93. https://doi.org/10.1037/a0033039

Wysocki T, Miller K, Greco P, et al. Behaviour therapy of families of adolescents with diabetes: effects on directly observed family interactions. Behav Ther 1999;30:507–25. https://doi.org/10.1016/S0005-7894(99)80022-7

Harvey JN. Psychosocial interventions for the diabetic patient. Diabetes Metab Syndr Obes 2015;8:29–43. http://dx.doi.org/10.2147/DMSO.S44352

Funnell MM, Anderson RM, Arnold MS, et al. Empowerment: an idea whose time has come in diabetes education. Diabetes Educ 1991; 17:37–41. https://doi.org/10.1177/014572179101700108

Graue M, Wentzel-Larsen T, Hanestad BR, Sovik O. Health-related quality of life and metabolic control in adolescents with diabetes: the role of parental care, control, and involvement. J Pediatr Nurs 2005;20:373–82. http://dx.doi.org/10.1016/j.pedn.2005.08.005

Barlow JH, Ellard DR. Psycho-educational interventions for children with chronic disease, parents and siblings: an overview of the research evidence base. Child Care Health Devel 2004;30:637–45. https://doi.org/10.1111/j.1365-2214.2004.00474.x

Anderson B, Ho J, Brackett J, Finkelstein D, Laffel L. Parental involvement in diabetes management tasks: relationships to blood glucose monitoring adherence and metabolic control in young adolescents with insulin-dependent diabetes mellitus. J Pediatr 1997;130:257–65. https://doi.org/10.1016/S0022-3476(97)70352-4

Forsander GA, Persson B, Sundelin J, et al. Metabolic control in children with insulin-dependent diabetes mellitus 5 years after diagnosis: early detection of patients at risk for poor metabolic control. Acta Paediatr 1998;87:857–64. https://doi.org/10.1111/j.1651-2227.1998.tb01551.x

Murphy H, Rayman G, Skinner TC. Psycho-educational interventions for children and young people with type 1 diabetes. Diabet Med 2006;23:935–43. http://dx.doi.org/10.1111/j.1464-5491.2006.01816.x

Whittemore R, Kanner S, Grey M. The influence of family on physiological and psychosocial health in youth with type 1 diabetes: a systematic review. In: Melnyk B, Fineout-Overholt E, eds. Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. Philadelphia: Lippincott Williams & Wilkins, 2004.

Boland EA, Grey M, Oesterle AL, Fredrickson L, Tamborlane WV. Continuous subcutaneous insulin infusion: a new way to lower risk of severe hypoglycaemia, improve metabolic control, and enhance coping in adolescents with type 1 diabetes. Diabetes Care 1999;22:1779–84. https://doi.org/10.2337/diacare.22.11.1779

Hains AA, Davies WH, Parton E, Totka J, Amoroso-Camarata J. A stress management intervention for adolescents with T1D. The Diabetes Educator 2000;26:417–24. https://doi.org/10.1177/014572170002600309

Mendez F, Belendez M. Effects of a behavioural intervention on treatment adherence and stress management in adolescents with IDDM. Diabetes Care 1997;20:1370–5. https://doi.org/10.2337/diacare.20.9.1370

Cook S, Herold K, Edidin DV, Briars R. Increasing problem solving in adolescents with type 1 diabetes: the Choices Diabetes Program. The Diabetes Educator 2002;28:115–24. https://doi.org/10.1177/014572170202800113

Harris MA, Mertlich D. Piloting home-based behavioural family systems therapy for adolescents with poorly controlled diabetes. Children’s Health Care 2003;32:65–79. https://doi.org/10.1207/S15326888CHC3201_5

Clark M, Hampson SE. Implementing a psychological intervention to improve lifestyle self-management in type 2 diabetes. Patient Educ Counsel 2001;42:247–56. https://doi.org/10.1016/S0738-3991(00)00128-2

Simmons D, Hartnell S, Watts J, et al. Effectiveness of a multidisciplinary team approach to the prevention of readmission from acute glycaemic events. Diabet Med 2015;32:1361–7. http://dx.doi.org/10.1111/dme.12779

Hofstede G. Culture’s Consequences. Comparing Values, Behaviours, Institutions and Organizations Across Nations. 2nd edn. Thousand Oaks, CA: Sage Publications, 2001.

Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edn. Hillsdale, NJ: Lawrence Earlbaum Associates,1988.




DOI: https://doi.org/10.15277/bjd.2018.177

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