Psychosocial Outcomes in Young Adolescents with Type 1 Diabetes Participating in Shared Medical Appointments.

OBJECTIVE For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school-aged youth. METHODS Youth with T1D, 11-13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed-effects models. RESULTS Eighty-six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the twelve-month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p=0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p=0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. CONCLUSIONS Participation in Team Clinic was associated with improved psychosocial outcomes in middle school-aged participants with T1D. This article is protected by copyright. All rights reserved.