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Title: Feasibility of an intervention using relational agents to improve family communication in type 1 diabetes

item Thompson, Deborah - Debbe
item CALLENDER, CHISHINGA - Children'S Nutrition Research Center (CNRC)
item GONYNOR, CAROLINE - Baylor College Of Medicine
item CULLEN, KAREN - Children'S Nutrition Research Center (CNRC)
item REDONDO, MARIA - Baylor College Of Medicine
item BUTLER, ASHLEY - Baylor College Of Medicine
item ANDERSON, BARBARA - Baylor College Of Medicine

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 7/15/2019
Publication Date: 9/9/2019
Citation: Thompson, D.J., Callender, C., Gonynor, C., Cullen, K.W., Redondo, M.J., Butler, A., Anderson, B.J. 2019. Feasibility of an intervention using relational agents to improve family communication in type 1 diabetes [abstract]. American Association of Diabetes Educators (AADE) 2019 Annual Conference. August 9-12, 2019; Houston, TX. Poster Presentation.

Interpretive Summary:

Technical Abstract: Family conflict and negative communication are common barriers to adolescent adherence of type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be successful in reducing conflict and low adherence to diabetes-related tasks. However, its reach and potential impact were limited by the need to deliver the program sessions in-person. Relational agents (i.e., computerized versions of humans) have been shown to appeal to diverse populations and may be an acceptable replacement for a human in technology-based behavior change interventions. Parent-teen dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate post intervention (post 1), and three months after post 1 (post 2), was used to assess feasibility. Assessments for the parents and teens included self-report data via online surveys (baseline, post 1, post 2) and telephone interviews (post 1, post 2). A priori feasibility criteria included an assessment of recruitment; completion; attrition; program satisfaction; therapeutic alliance; attitudes towards the relational agent; and data collection. The Institutional Review Board at Baylor College of Medicine approved the protocol (H-37245). Descriptive statistics were calculated on survey data. Separate analyses were calculated for parents and teens. Results were compared to the criteria to make a determination of feasibility. Audio recordings of interviews were reviewed and key point summaries were created to capture important thoughts that emerged from teen and parent interviews to enhance understanding of the results. Verbatim quotes were used to provide voice to teen and parent perceptions and experiences. Twenty-seven 10-15 year olds with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were: recruitment goals were met (n=20); b) families completed >75% of the modules; c) attrition rate was < 10%; d) program satisfaction was high (>80% of families); e) therapeutic alliance was high (average score of >60/84); f) families expressed positive attitudes towards the relational agent (average item score of >5 on >4 items); g) >80% of data were collected at post 1 and post 2; and h) few technical issues ( < 10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that teens and parents had positive reactions to both the content and approach. The Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with a teen who has type 1 diabetes.