Satisfaction With Participation in the First STEPS Behavioral Intervention: Experiences of Parents of Young Children With Newly Diagnosed Type 1 Diabetes

Overview

Journal J Pediatr Psychol

Publisher Oxford University Press

Date 2023 Jun 21

PMID 37344161

Authors

Marissa N Baudino

Hailey Inverso

Christine Wang

Carrie Tully

Wendy Levy

Lauren Clary

Katherine A Gallagher

Maureen Monaghan

Randi Streisand

Marisa E Hilliard

Affiliations

Soon will be listed here.

Abstract

Objective: Parents of young children with new-onset type 1 diabetes (T1D) often experience significant distress and struggle with T1D management during a challenging developmental stage. The First STEPS (Study of Type 1 in Early childhood and Parenting Support) trial evaluated a stepped-care behavioral intervention comprising increasingly intensive intervention steps (peer parent coach, cognitive-behavioral counseling, consultations with diabetes educator and psychologist) based on need. The intervention improved parental depressive symptoms compared to usual care. Subsequently, we examined parent satisfaction with the intervention to guide potential implementation and refinement for future trials.

Methods: Participants were 157 parents of young children newly diagnosed with T1D. At 9 months post randomization, n = 153 completed satisfaction questionnaires and n = 17 completed qualitative interviews. Satisfaction ratings about trial procedures and each intervention step were summarized. We used thematic analysis with the interview transcripts to generate themes related to participants' experiences in the trial overall and intervention specifically. We explored differences in themes between participants who did versus did not respond to the intervention and among those who experienced different intervention steps.

Results: Most participants in both arms rated study participation and methods positively (>95%), and those completing interviews described high satisfaction with study procedures overall, retention incentives, and contact with study staff. Intervention participants' satisfaction ratings were high across steps. Two qualitative themes reflected satisfaction with the intervention enhancing self-efficacy and social support.

Conclusions: High satisfaction suggests implementing a stepped-care behavioral intervention as part of routine clinical care following T1D diagnosis would be well received.

Citing Articles

Experiences of Parent Coaches in an Intervention for Parents of Young Children Newly Diagnosed with Type 1 Diabetes.

Tully C, Sinisterra M, Levy W, Wang C, Barber J, Inverso H Children (Basel). 2024; 11(9).

PMID: 39334569 PMC: 11430371. DOI: 10.3390/children11091036.

References

Lawrence J, Divers J, Isom S, Saydah S, Imperatore G, Pihoker C . Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017. JAMA. 2021; 326(8):717-727. PMC: 8385600. DOI: 10.1001/jama.2021.11165. View

Cope D . Methods and meanings: credibility and trustworthiness of qualitative research. Oncol Nurs Forum. 2013; 41(1):89-91. DOI: 10.1188/14.ONF.89-91. View

Monaghan M, Hilliard M, Cogen F, Streisand R . Supporting parents of very young children with type 1 diabetes: results from a pilot study. Patient Educ Couns. 2010; 82(2):271-4. PMC: 2965294. DOI: 10.1016/j.pec.2010.04.007. View

Monaghan M, Bryant B, Inverso H, Moore H, Streisand R . Young Children with Type 1 Diabetes: Recent Advances in Behavioral Research. Curr Diab Rep. 2022; 22(6):247-256. PMC: 9013975. DOI: 10.1007/s11892-022-01465-0. View

Ramos A, Cooke F, Miller E, Herbert L . The Food Allergy Parent Mentoring Program: A Pilot Intervention. J Pediatr Psychol. 2021; 46(7):856-865. DOI: 10.1093/jpepsy/jsab019. View

Hilliard M, Commissariat P, Kanapka L, Laffel L, Levy W, Harrington K . Development and delivery of a brief family behavioral intervention to support continuous glucose monitor use in young children with type 1 diabetes. Pediatr Diabetes. 2022; 23(6):792-798. PMC: 9542880. DOI: 10.1111/pedi.13349. View

Wade S, Cassedy A, Sklut M, Taylor H, McNally K, Kirkwood M . The Relationship of Adolescent and Parent Preferences for Treatment Modality With Satisfaction, Attrition, Adherence, and Efficacy: The Coping With Head Injury Through Problem-Solving (CHIPS) Study. J Pediatr Psychol. 2018; 44(3):388-401. DOI: 10.1093/jpepsy/jsy087. View

Whittemore R, Jaser S, Chao A, Jang M, Grey M . Psychological experience of parents of children with type 1 diabetes: a systematic mixed-studies review. Diabetes Educ. 2012; 38(4):562-79. PMC: 3401246. DOI: 10.1177/0145721712445216. View

Klages K, Ankney R, Berlin K, Keenan M, Wood N, Semenkovich K . Validity, Reliability, and Measurement Invariance of the Diabetes Stress Questionnaire-Short Form. J Pediatr Psychol. 2018; 44(4):442-452. DOI: 10.1093/jpepsy/jsy078. View

10.

Tully C, Clary L, Monaghan M, Levy W, Hilliard M, Streisand R . Implementation and Preliminary Feasibility of an Individualized, Supportive Approach to Behavioral Care for Parents of Young Children Newly Diagnosed With Type 1 Diabetes. Cogn Behav Pract. 2021; 28(2):293-308. PMC: 8136148. DOI: 10.1016/j.cbpra.2020.06.006. View

11.

Cathey M, Gaylord N . Picky eating: a toddler's continuing approach to mealtime. Pediatr Nurs. 2004; 30(2):101-7. View

12.

Kazak A . Families of chronically ill children: a systems and social-ecological model of adaptation and challenge. J Consult Clin Psychol. 1989; 57(1):25-30. DOI: 10.1037//0022-006x.57.1.25. View

13.

Noser A, Dai H, Marker A, Raymond J, Majidi S, Clements M . Parental depression and diabetes-specific distress after the onset of type 1 diabetes in children. Health Psychol. 2018; 38(2):103-112. PMC: 6407701. DOI: 10.1037/hea0000699. View

14.

Wu Y, Thompson D, Aroian K, McQuaid E, Deatrick J . Commentary: Writing and Evaluating Qualitative Research Reports. J Pediatr Psychol. 2016; 41(5):493-505. PMC: 4888120. DOI: 10.1093/jpepsy/jsw032. View

15.

Hilliard M, Tully C, Monaghan M, Hildebrandt T, Wang C, Barber J . First STEPS: Primary Outcomes of a Randomized, Stepped-Care Behavioral Clinical Trial for Parents of Young Children With New-Onset Type 1 Diabetes. Diabetes Care. 2022; 45(10):2238-2246. PMC: 9643142. DOI: 10.2337/dc21-2704. View

16.

Smaldone A, Ritholz M . Perceptions of parenting children with type 1 diabetes diagnosed in early childhood. J Pediatr Health Care. 2011; 25(2):87-95. PMC: 3053084. DOI: 10.1016/j.pedhc.2009.09.003. View

17.

Law E, Fales J, Beals-Erickson S, Failo A, Logan D, Randall E . A Single-Arm Feasibility Trial of Problem-Solving Skills Training for Parents of Children with Idiopathic Chronic Pain Conditions Receiving Intensive Pain Rehabilitation. J Pediatr Psychol. 2016; 42(4):422-433. PMC: 6075428. DOI: 10.1093/jpepsy/jsw087. View

18.

Herbert L, Sweenie R, Kelly K, Holmes C, Streisand R . Using qualitative methods to evaluate a family behavioral intervention for type 1 diabetes. J Pediatr Health Care. 2013; 28(5):376-85. PMC: 3999309. DOI: 10.1016/j.pedhc.2013.09.002. View

19.

Rechenberg K, Grey M, Sadler L . Stress and Posttraumatic Stress in Mothers of Children With Type 1 Diabetes. J Fam Nurs. 2017; 23(2):201-225. PMC: 5611825. DOI: 10.1177/1074840716687543. View

20.

Shneider C, Hilliard M, Monaghan M, Tully C, Wang C, Sinisterra M . Recruiting and retaining parents in behavioral intervention trials: Strategies to consider. Contemp Clin Trials. 2021; 108:106502. PMC: 8453094. DOI: 10.1016/j.cct.2021.106502. View