Lawrence Fisher1, William Polonsky2, Vicky Bowyer3, Danielle Hessler3. 1. University of California, San Francisco, San Francisco, CA, USA. Electronic address: larry.fisher@ucsf.edu. 2. University of California, San Diego, San Diego, CA, USA; Behavioral Diabetes Institute, San Diego, CA, USA. 3. University of California, San Francisco, San Francisco, CA, USA.
Abstract
AIMS: To assess between-group differences in participant experiences in a two-arm diabetes distress (DD) reduction RCT and to determine their relationship to clinical outcomes (reductions in DD and HbA1C). METHODS: For high DD adults with Type 1 diabetes and HbA1c ≥7.5% participating in T1-REDEEM, we evaluated post intervention 5-point ratings of overall program "helpfulness" and program component "helpfulness," along with open-ended feedback statements using 10 qualitative codes. We compared responses of those in OnTrack, a distressed-focused intervention, with KnowIt, an education/management intervention. RESULTS: Those in OnTrack reported significantly higher levels of overall program helpfulness and greater helpfulness of each component of the program, greater group support, far fewer negative experiences, and more active and meaningful group engagement than those who participated in KnowIt. Ratings of helpfulness were unrelated to reductions in DD and HbA1C in both study arms. As previously reported, these findings occurred despite significant reductions in both DD and HbA1C in both arms with no between-group differences. CONCLUSIONS: Findings highlight the importance of addressing the personal experience of diabetes interventions in clinical care as separate, distinct outcomes. Personal experience may not always be related to changes in traditional clinical indicators.
AIMS: To assess between-group differences in participant experiences in a two-arm diabetes distress (DD) reduction RCT and to determine their relationship to clinical outcomes (reductions in DD and HbA1C). METHODS: For high DD adults with Type 1 diabetes and HbA1c ≥7.5% participating in T1-REDEEM, we evaluated post intervention 5-point ratings of overall program "helpfulness" and program component "helpfulness," along with open-ended feedback statements using 10 qualitative codes. We compared responses of those in OnTrack, a distressed-focused intervention, with KnowIt, an education/management intervention. RESULTS: Those in OnTrack reported significantly higher levels of overall program helpfulness and greater helpfulness of each component of the program, greater group support, far fewer negative experiences, and more active and meaningful group engagement than those who participated in KnowIt. Ratings of helpfulness were unrelated to reductions in DD and HbA1C in both study arms. As previously reported, these findings occurred despite significant reductions in both DD and HbA1C in both arms with no between-group differences. CONCLUSIONS: Findings highlight the importance of addressing the personal experience of diabetes interventions in clinical care as separate, distinct outcomes. Personal experience may not always be related to changes in traditional clinical indicators.
Authors: Lawrence Fisher; Danielle Hessler; William H Polonsky; Umesh Masharani; Susan Guzman; Vicky Bowyer; Lisa Strycker; Andrew Ahmann; Marina Basina; Ian Blumer; Charles Chloe; Sarah Kim; Anne L Peters; Martha Shumway; Karen Weihs; Patricia Wu Journal: Diabetes Care Date: 2018-07-05 Impact factor: 19.112
Authors: Johan Jendle; Andreas L Birkenfeld; William H Polonsky; Robert Silver; Kari Uusinarkaus; Thomas Hansen; Jonas Håkan-Bloch; Sayeh Tadayon; Melanie J Davies Journal: Diabetes Obes Metab Date: 2019-07-12 Impact factor: 6.577