Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families

Hilliard, Marisa E.; Powell, Priscilla W.; Anderson, Barbara J.

doi:10.1037/a0040359

Cited by 158Diabetes Management and EducationDiabetes Management and ResearchDiabetes and associated disorders

Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families

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Hilliard, Marisa E., Powell, Priscilla W., Anderson, Barbara J.·2016·American Psychologist

DOI 10.1037/a0040359PMC PMC5724567

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Abstract

As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals' and families' unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. (PsycINFO Database Record

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For youth with diabetes, family-based behavioral intervention packages and multisystem interventions that facilitate health behavior change demonstrate benefit for increasing management behaviors and improving glycemic outcomes.
“For youth with diabetes, family-based behavioral intervention packages and multisystem interventions that facilitate health behavior change demonstrate benefit for increasing management behaviors and improving glycemic outcomes (301).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023 (2023) · cites this paper as [301]
Behavioral strategies and multicomponent interventions help people with diabetes and their caregivers or family members develop health behavior routines and overcome barriers to self-management behaviors.
“Evidence supports using a variety of behavioral strategies and multicomponent interventions to help people with diabetes and their caregivers or family members develop health behavior routines and overcome barriers to self-management behaviors (300-302).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023 (2023) · cites this paper as [301]

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Bronfenbrenner U 1979 The ecology of human development: Experiments by design and nature Cambridge, MA Harvard University Press
Miller WR Rollnick S 2013 Motivational interviewing: Helping people change 3rd New York, NY Guilford Press

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5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023
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ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes
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Safety Evaluation of the MiniMed 670G System in Children 7–13 Years of Age with Type 1 Diabetes
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American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s014 · Cited by 173 · see citing works
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The social context of managing diabetes across the life span.
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Psychology, technology, and diabetes management.
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Factors Determining the Success of Therapeutic Lifestyle Interventions in Diabetes – Role of Partner and Family Support
Gupta, L., Khandelwal, D., Maharaj Agrasen Hopsital, P. B., Lal, P. R., Gupta, Y., Kalra, S., & Dutta, D. (2019) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2019.15.1.18 · Cited by 68 · see citing works
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Evidence for the Efficacy and Effectiveness of Systemic Family Therapy
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Behavioral Lifestyle Interventions for Weight Loss in Overweight or Obese Patients with Type 2 Diabetes: A Systematic Review of the Literature
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Solutions to Address Inequity in Diabetes Technology Use in Type 1 Diabetes: Results from Multidisciplinary Stakeholder Co-creation Workshops
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Frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus in Najran, Saudi Arabia
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Depression in Youth-Onset Type 2 Diabetes
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Risk Factors and Lifestyle Interventions
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Randomized Trial of a Positive Psychology Intervention for Adolescents With Type 1 Diabetes
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Improving the Well-being of Adolescents With Type 1 Diabetes During the COVID-19 Pandemic: Qualitative Study Exploring Acceptability and Clinical Usability of a Self-compassion Chatbot
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Sex-Related Differences in Cardiovascular Disease Risk Profile in Children and Adolescents with Type 1 Diabetes
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Family-centered interventions for children and adolescents with type 1 diabetes mellitus: an integrative review
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Optimizing Recruitment of Black Adolescents into Behavioral Research: A Multi-Center Study
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Promoting Resilience in Stress Management for Adolescents With Type 1 Diabetes
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All together: Integrated care for youth with type 1 diabetes
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Type 1 Doing Well: Pilot Feasibility and Acceptability Study of a Strengths-Based mHealth App for Parents of Adolescents with Type 1 Diabetes
Hilliard, M. E., Cao, V. T., Eshtehardi, S. S., Minard, C. G., Saber, R., Thompson, D. I., Karaviti, L. P., & Anderson, B. J. (2020) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2020.0048 · Cited by 23 · see citing works
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Plasma homocysteine level and uveitis in Behçet's disease.
Okka, M., Öztürk, M., Koçkar, M. C., Bavbek, N., Rasier, Y., Gündüz, K., & Korkar, M. C. (2002) · PubMed · Cited by 23 · see citing works
Exploring the views of adolescents with type 1 diabetes on digital mental health interventions: What functionality and content do they want?
Boggiss, A. L., Consedine, N. S., Schache, K. R., Wallace‐Boyd, K., Cao, N., Hofman, P. L., & Serlachius, A. S. (2021) · Diabetic Medicine · doi:10.1111/dme.14591 · Cited by 19 · see citing works
Small Interventions for Big Change: Brief Strategies for Distress and Self-Management Amongst Youth with Type 1 Diabetes
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A Systematic Review of Medication Adherence Interventions in Pediatric Sickle Cell Disease
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Insulin restriction or omission in Type 1 Diabetes Mellitus: a meta-synthesis of individuals’ experiences of diabulimia
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Short-Term Effects of COVID-19 Lockdown in Italian Children and Adolescents with Type 1 Diabetes Mellitus: The Role of Separation Anxiety
Riso, D. D., Bertini, S., Spaggiari, S., Olivieri, F., Zaffani, S., Comerlati, L., Marigliano, M., Piona, C. A., & Maffeis, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115549 · Cited by 18 · see citing works
First STEPS: Primary Outcomes of a Randomized, Stepped-Care Behavioral Clinical Trial for Parents of Young Children With New-Onset Type 1 Diabetes
Hilliard, M. E., Tully, C., Monaghan, M. C., Hildebrandt, T., Wang, C. H., Barber, J. R., Clary, L., Gallagher, K., Levy, W. L., Cogen, F. R., et al. (2022) · Diabetes Care · doi:10.2337/dc21-2704 · Cited by 21 · see citing works
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Teen and parental perspectives regarding transition of care in type 1 diabetes
Holtz, B., Mitchell, K. M., Holmstrom, A. J., Cotten, S. R., Hershey, D. S., Dunneback, J. K., Jimenez‐Vega, J., & Wood, M. A. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.104800 · Cited by 17 · see citing works
Parent–adolescent dyadic diabetes distress: Associations with A1c and diabetes-related strengths.
Vesco, A. T., Feldman, M. A., Evans, M. A., & Weissberg-Benchell, J. A. (2018) · Families Systems & Health · doi:10.1037/fsh0000358 · Cited by 16 · see citing works
Psychoeducation for Children with Chronic Conditions: A Systematic Review and Meta-analysis
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Caring for individuals with Type 1 Diabetes Mellitus who restrict and omit insulin for weight control: Evidence-based guidance for healthcare professionals
Goddard, G., & Oxlad, M. (2022) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2022.109783 · Cited by 15 · see citing works
Testing Usability and Feasibility of a Mobile Educator Tool for Pediatric Diabetes Self-Management: Mixed Methods Pilot Study
Otis, M., Zhu, J., Mustafa-Kutana, S. N., Bernier, A. V., Shum, J. M., Dupre, A. A. S., & Wang, M. L. (2020) · JMIR Formative Research · doi:10.2196/16262 · Cited by 16 · see citing works
Special Considerations in the Systematic Psychosocial Screening of Youth with Type 1 Diabetes
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Impact of Diabetes Self-Management Education/Support on Self-Reported Quality of Life in Youth With Type 1 or Type 2 Diabetes
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Participants’ experience and engagement in check it!: A positive psychology intervention for adolescents with type 1 diabetes.
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Protocol for a feasibility study: a brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating
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Glycemic outcomes of a family-focused intervention for adults with type 2 diabetes: Main, mediated, and subgroup effects from the FAMS 2.0 RCT
Nelson, L. A., Spieker, A. J., Greevy, R. A., Roddy, M. K., LeStourgeon, L. M., Bergner, E. M., El-Rifai, M., Aikens, J. E., Wolever, R. Q., Elasy, T. A., et al. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110991 · Cited by 15 · see citing works
Adolescents with Type 2 Diabetes: Overcoming Barriers to Effective Weight Management
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Disparities in Patient- and Family-Centered Care Among Children With Health Conditions
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Type 2 Diabetes Mellitus in Children and Adolescents: Early Prevention and Non-Drug Therapy
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Impact of Digitally Enabled Peer Support Interventions on Diabetes Distress and Depressive Symptoms in People Living with Type 1 Diabetes: A Systematic Review
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Integrated Behavioral Health in Pediatric Subspecialty Clinics
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Impact and Cost-Effectiveness of Integrated Psychology Services in a Pediatric Endocrinology Clinic
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Protocol for the Promoting Resilience in Stress Management (PRISM) intervention: A multi-site randomized controlled trial for adolescents with type 1 diabetes
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Strengths-Based Behavioral Intervention for Parents of Adolescents With Type 1 Diabetes Using an mHealth App (Type 1 Doing Well): Protocol for a Pilot Randomized Controlled Trial
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All systems go: An ecological perspective of behavioral health for youth with type 1 diabetes.
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Adolescence and Emerging Adulthood
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Toward the Development of a Culturally Humble Intervention to Improve Glycemic Control and Quality of Life among Adolescents with Type-1 Diabetes and Their Families
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Involvement of Racially and Ethnically Minoritized Youths in Behavioral Type 1 Diabetes Interventions: A Systematic Review
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Communication and coping intervention for mothers of adolescents with type 1 diabetes: Rationale and trial design
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Authors: Hilliard, M. E., Powell, P. W., & Anderson, B. J.
ORCID: Hilliard, Marisa E.
Anderson, Barbara J.
Venue: American Psychologist
Publisher: American Psychological Association (APA)
Published: 2016-10
Volume: 71
Issue: 7
Pages: 590-601
ISSN: 0003-066X (ISSN-L)
1935-990X
DOI: 10.1037/a0040359
PMC: PMC5724567
OpenAlex: W2528793147
Cited by: 157
References: 94
Citations by year: 2026: 14 · 2025: 19 · 2024: 13 · 2023: 21 · 2022: 19 · 2021: 17 · 2020: 23 · 2019: 8 · 2018: 9 · 2017: 9 · 2016: 4
FWCI: 10.04
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (am, 367 d)
Locations: American Psychologist (publishedVersion, other-oa)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (K12 DK097696)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords: type 1 diabetes, type 2 diabetes, youth-onset diabetes, diabetes self-management, family involvement, behavioral interventions, mobile health, behavioral health integration, glycemic control, behavioral theory, cost-effectiveness, pediatric diabetes care
MeSH terms: Adolescent, Behavior Therapy, Child, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Family, Humans, Patient Compliance, Self Care, Social Support, Evidence-Based Medicine

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Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families

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