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An internet coping skills training program for youth with type 1 diabetes: six-month outcomes.

ABSTRACT: Managing Type 1 diabetes (T1D) during adolescence can be challenging, and there is a need for accessible interventions to help adolescents cope with diabetes-related stress.The aim of this study was to compare an Internet coping skills training (TEENCOPE) intervention to an Internet educational intervention (Managing Diabetes) for adolescents with T1D. Moderators of program efficacy were evaluated.The study was a multisite clinical trial (n = 320) with data collected at baseline, 3 months, and 6 months. Data were collected on the primary outcomes of physiologic (A1C) and psychosocial (quality of life) and on the secondary outcomes of behavioral (self-management) and psychosocial (stress, coping self-efficacy, social competence, family conflict) variables consistent with the conceptual framework. Data were analyzed using mixed-model analyses with an intent-to-treat approach.There were no significant between-group treatment effects 6 months postintervention on primary outcomes. The Managing Diabetes youth showed a significant increase in social competence compared to the TEENCOPE youth. There were significant time effects for TEENCOPE (decreased stress and increased coping) and Managing Diabetes (improved diabetes quality of life).Youth with T1D transitioning to adolescence may need both structured diabetes education and coping skills to improve health outcomes. There may be a higher potential to reach adolescents with Type 1 diabetes of varying race and ethnicity via Internet interventions.

SUBMITTER: Whittemore R

PROVIDER: S-EPMC3623558 | biostudies-literature | 2012 Nov-Dec

REPOSITORIES: biostudies-literature

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An internet coping skills training program for youth with type 1 diabetes: six-month outcomes.

Whittemore Robin R Jaser Sarah S SS Jeon Sangchoon S Liberti Lauren L Delamater Alan A Murphy Kathleen K Faulkner Melissa S MS Grey Margaret M

Nursing research 20121101 6

<h4>Background</h4>Managing Type 1 diabetes (T1D) during adolescence can be challenging, and there is a need for accessible interventions to help adolescents cope with diabetes-related stress.<h4>Objectives</h4>The aim of this study was to compare an Internet coping skills training (TEENCOPE) intervention to an Internet educational intervention (Managing Diabetes) for adolescents with T1D. Moderators of program efficacy were evaluated.<h4>Methods</h4>The study was a multisite clinical trial (n = ...[more]

PMID: 22960587

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Project description:BackgroundPatients with Systemic Lupus Erythematosus (SLE) often experience pain and other symptoms that negatively impact quality of life. Interventions that enhance the use of behavioral and cognitive coping strategies may lead to improved outcomes among patients with SLE. Pain coping skills training (PCST) programs have been shown to improve outcomes among patients with other rheumatic conditions, but there have been no trials of PCST among patients with SLE. This study was a preliminary assessment of the feasibility and efficacy of painTRAINER, an automated, internet-based PCST program, among patients with SLE.MethodsParticipants (n = 60) with SLE from one health care system were randomly assigned with equal allocation to painTRAINER or a wait list control group. PainTRAINER involves 8 modules; participants were instructed to complete one module weekly, along with practice activities for each cognitive or behavioral coping skill. Outcome measures were assessed at baseline and 9-week follow-up, including the Pain Catastrophizing Scale, PROMIS Subscales (Pain Interference, Physical Function, Sleep Disturbance, Anxiety, Depression, Fatigue and Participation), and the LupusPRO questionnaire. Mean changes in outcomes from baseline to follow up and Cohen's d effect sizes were computed.ResultsEffect sizes for the painTRAINER group (relative to the wait list group) were small, with changes being greatest for the PROMIS Depression score (d = - 0.32). Among those randomized to the painTRAINER group, 50% accessed the program ("painTRAINER users"). Most of those who did not access the program stated that they did not receive instructions via email. Effect sizes for "painTRAINER users" (relative to wait list) were larger than for the whole painTRAINER group: Pain Catastrophizing d = - 0.60, PROMIS Pain Interference d = - 0.3., PROMIS Depression d = - 0.44, LupusPRO Health-Related Quality of Life d = 0.30.ConclusionsPainTRAINER users reported meaningful improvements in multiple physical and psychological outcomes, supporting the potential of PCST programs to benefit individuals with SLE. However, strategies are needed to improve engagement with the program and tailor content to comprehensively address key SLE symptoms and challenges.Trial registrationNCT03933839 , May 1, 2019.

Project description:Interventions: Controlled intervention will compare microbiome changes over six-months between cancer types. All participants will complete a four-week training program, supervised by an Accredited Exercise Physiologist or equivalent. This initial program will require attendance three times per week and entail a high-intensity interval training protocol of 4x4 minute intervals at 85-95% HRpeak, with three minute active recovery bouts between each interval. Attendance will be recorded in a supervised-training logbook. Similarly, adherence to 85-95% HRpeak during intervals will be recorded. This protocol requires a total of 38 minutes exercise and all exercise will be conducted on a cycle ergometer. The purpose of this period is to ensure all participants understand the exercise protocol and are able to complete it safely during the remainder of the study. Participants will then be provided with access to a facility with all required equipment available and encouraged to complete three sessions per week for the next six months. Participants will also be advised to maintain 150 minutes of moderate intensity or 75 minutes of vigorous intensity or a combination, therefore meeting the Australian exercise oncology guidelines. Participants will keep a log of the date and duration of exercise completed. Participants will be recruited from the Brisbane area, with the intervention being run from the University of Queensland and partnered gyms in the wider Brisbane area. Primary outcome(s): Human gut microbiome taxa abundance in stool samples assessed via 16S rRNA sequencing. This composite outcome will also provide representation of microbial diversity. [Participants will deposit a stool sample within the three days immediately prior to each testing occasion. Testing time-points will be at baseline (prior to supervised training), following the 4-weeks supervised training, and at three- and six-months (primary endpoint) following supervised training.] Study Design: Purpose: Treatment; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Single group;Type of endpoint: Efficacy

Project description:BackgroundExercise training may have the potential to improve post-thrombotic syndrome, a frequent, chronic complication of deep venous thrombosis. We conducted a randomized controlled two-centre pilot trial to assess the feasibility of a multicentre-based evaluation of a six-month exercise training program to treat post-thrombotic syndrome and to obtain preliminary data on the effectiveness of such a program.MethodsPatients were randomized to receive exercise training (a six-month trainer-supervised program) or control treatment (an education session with monthly phone follow-ups). Levels of eligibility, consent, adherence and retention were used as indicators of study feasibility. Primary outcomes were change from baseline to six months in venous disease-specific quality of life (as measured using the Venous Insufficiency Epidemiological and Economic Study Quality of Life [VEINES-QOL] questionnaire) and severity of post-thrombotic syndrome (as measured by scores on the Villalta scale) in the exercise training group versus the control group, assessed by t tests. Secondary outcomes were change in generic quality of life (as measured using the Short-Form Health Survey-36 [SF-36] questionnaire), category of severity of post-thrombotic syndrome, leg strength, leg flexibility and time on treadmill.ResultsOf 95 patients with post-thrombotic syndrome, 69 were eligible, 43 consented and were randomized, and 39 completed the study. Exercise training was associated with improvement in VEINES-QOL scores (exercise training mean change 6.0, standard deviation [SD] 5.1 v. control mean change 1.4, SD 7.2; difference 4.6, 95% CI 0.54 to 8.7; p = 0.027) and improvement in scores on the Villalta scale (exercise training mean change -3.6, SD 3.7 v. control mean change -1.6, SD 4.3; difference -2.0, 95% CI -4.6 to 0.6; p = 0.14). Most secondary outcomes also showed greater improvement in the exercise training group.InterpretationExercise training may improve post-thrombotic syndrome. It would be feasible to definitively evaluate exercise training as a treatment for post-thrombotic syndrome in a large multicentre trial.

Project description:BackgroundPersistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction.ObjectiveThe purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function.DesignAn assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted.SettingThe study will be conducted in a community setting.ParticipantsThe participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA.InterventionParticipants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention.MeasurementsOutcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks.LimitationsA self-reported diagnosis of persistent hip pain will be used.ConclusionsThe findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision.

Project description:ObjectivePillars4Life is an educational program that teaches coping skills to cancer patients in a virtual group setting; it was recently implemented at 17 hospitals across the USA. The cost-effective, scalable, and assessable Pillars4Life curriculum targets psychosocial resources (e.g., self-efficacy and coping skills) as a means to reduce symptoms (e.g., depression, anxiety, and posttraumatic stress) and enhance quality of life.MethodsCancer patients were recruited from hospitals that received the LIVESTRONG Community Impact Project Award to enroll in a pilot study of Pillars4Life. Consenting participants met with a certified instructor weekly for 10 weeks in a virtual environment; the manualized intervention trained participants in personal coping skills. Longitudinal assessments over 6 months were assessed using validated instruments to determine changes in Pillars4Life targeted resources and outcomes. Multiple linear regression models examined the relationship between changes in targeted resources and changes in outcome from baseline to 3 months post-intervention.ResultsParticipants (n = 130) had the following characteristics: mean age of 56 ± 11 years, 87% women, 11% non-Caucasian, and 77% with college degree. At 3- and 6-month follow-up, mean scores improved on all key outcome measures such as depression (Patient Health Questionnaire), anxiety (Generalized Anxiety Disorder), posttraumatic stress (Posttraumatic Stress Disorder Checklist), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), and well-being (Functional Assessment of Cancer Therapy-General) from baseline (all p < 0.01); results were most pronounced among participants who reported ≥4/10 on the Distress Thermometer at baseline (all p < 0.001). Changes in each targeted resource were associated with 3-month improvements in at least one outcome.ConclusionsParticipation in the Pillars4Life program was associated with statistically and clinically significant improvements in scores on pre-specified outcomes and targeted resources.

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An internet coping skills training program for youth with type 1 diabetes: six-month outcomes.

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An internet coping skills training program for youth with type 1 diabetes: six-month outcomes.

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