Self-management problem solving for adolescents with type 1 diabetes: intervention processes associated with an Internet program

Abstract

Objective: Describe intervention processes associated with an Internet self-management problem solving program for adolescents with type 1 diabetes, and relate participant characteristics to program use.

Methods: Forty-one adolescents with type 1 diabetes, aged 13-17, participated in an Internet intervention.

Results: Participants reported psychosocial self-management barriers related to social issues (45%), time pressures (22%), and emotions (25%). Most adolescents (76%) completed the two guided problem solving cycles, and most (97%) problems were appropriate and specific to diabetes. Of the 61 diabetes problems reported, 92% were mostly or completely solved. Baseline hemoglobin A1c, diabetes duration, and age were not related to online activities, however females posted more often to the forum (U=130.0, Z=2.13, p=.033). The majority of parents (87%) interacted with their child about the website.

Conclusion: Adolescents experience psychosocial barriers to self-management that can be addressed by teaching problem solving via the Internet.

Practice implications: An Internet self-management problem solving program with minimal external support provides a viable option for diabetes clinics to improve pediatric diabetes outcomes.