JMIR Publications

ABSTRACT

Background:

Family conflict can reduce teen adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in-person. Relational agents (i.e., computerized versions of humans) have been shown to appeal to diverse agents and may be an acceptable replacement for a human in technology-based behavior change interventions.

Objective:

The purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork in-person intervention, delivered over the internet and guided by a relational agent.

Methods:

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, and three months later was used to assess feasibility. 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

Results:

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.

Conclusions:

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.