Promoting Resilience in Stress Management for Adolescents With Type 1 Diabetes: A Randomized Clinical Trial
Authors' conclusion
The findings in this randomized clinical trial of psychosocial and behavioral improvements associated with PRISM at 12 months illustrate the value of a strengths-based intervention. Integrating resilience skills-building with traditional diabetes care may be a promising approach for improving outcomes among adolescents with T1D and elevated diabetes distress.
Study context
- Population
- Adolescents aged 13 to 18 years with T1D for at least 12 months and elevated diabetes distress, 2 children's hospitals (Seattle, Washington; Houston, Texas); mean (SD) age 15.7 (1.6) years, 56% female, baseline mean (SD) hemoglobin A1c (HbA1c) 8.7% (2.0%)followed up 12 months
- Participants
- 172 adolescents
- Comparison
- Promoting Resilience in Stress Management (PRISM) vs usual care
- Primary endpoint
- 2 primary outcomes: diabetes distress and HbA1c levels
- Follow-up
- 6 and 12 months after baseline
Methodological detailsphase 3, parallel, 1:1 randomized, 2 children's hospitals, Conducted January 1, 2020, to November 30, 2022
- Phase 3
- Parallel
- 1:1 randomized
- 2 children's hospitals
- Conducted January 1, 2020, to November 30, 2022
Primary result
As reported in the abstract
6 and 12 months
- HbA1c at 6 months; no difference
- β −0.21 (95% CI −0.65 to 0.22); P = 0.33
- Diabetes distress at 6 months; no difference
- β −2.71 (95% CI −6.31 to 0.90); P = 0.14
- HbA1c at 12 months; no statistically significant difference
- β −0.26 (95% CI −0.72 to 0.19); P = 0.25
- Diabetes distress at 12 months; significantly greater amelioration with PRISM
- β −4.59 (95% CI −8.25 to −0.94); P = 0.01
Secondary outcomes
| Outcome | β (95% CI) | P value |
|---|---|---|
| Self-management behaviors · 6 months | 2.25 (−0.30 to 4.80) | P = 0.08 |
| Self-management behaviors · 12 monthsSignificantly greater improvement with PRISM | 3.4 (0.9–5.9) | P = 0.01 |
Self-management behaviors · 6 months
- No differences in any participant-reported outcome at 6 months
Original publication
Promoting Resilience in Stress Management for Adolescents With Type 1 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. Published 1 August 2024. doi:10.
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