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Cited by 23Diabetes Management and ResearchDiabetes Management and EducationAdolescent and Pediatric Healthcare

Youth Involvement in the Decision to Start CGM Predicts Subsequent CGM Use

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Miller, Victoria A., Xiao, Rui, Slick, Nathalie, Feudtner, Chris, Willi, Steven M.·2020·Diabetes Care
DOI 10.2337/dc20-0348PMC PMC7510031
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Abstract

OBJECTIVE: The ability of continuous glucose monitoring (CGM) to improve diabetes outcomes depends upon consistent use. To identify factors that facilitate long-term use of CGM, this study tested the hypothesis that youth involvement in the decision to initiate this therapy would influence subsequent CGM use and that CGM self-efficacy and satisfaction mediate this relationship. RESEARCH DESIGN AND METHODS: Before initiating CGM, parent-youth dyads (i.e., pairs) from an academic endocrinology clinic completed assessments, including a measure of the child’s involvement in the decision to start CGM. Two months into CGM use, youth completed measures of CGM self-efficacy and satisfaction. Fidelity of CGM use between weeks 5 and 12 was accessed via a cloud-based data repository. Hypotheses were tested with linear mixed-effects models, accounting for patients clustered within provider and repeated measures within patients. RESULTS: CGM use in 108 dyads (youth mean age 13.4 ± 2.7 years; 73% White) was positively predicted by baseline parent report of youth involvement in the CGM decision (P < 0.0001), and this relationship was mediated by youth’s perceptions of CGM self-efficacy (P < 0.0001) and hassle (P = 0.014). So, when the youth shared their opinions about CGM with parents and participated in the decision to start, they perceived higher self-efficacy and lower hassle at 2-month follow-up, which predicted more days of use. This pattern held in models adjusting for youth race and sex and family income. CONCLUSIONS: To achieve maximum clinical benefit from CGM use, providers should facilitate youth involvement in the decision to initiate the device.

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Authors
Miller, V. A., Xiao, R., Slick, N., Feudtner, C., & Willi, S. M.
Affiliations
Children's Hospital of Philadelphia (US)
Corresponding author
Miller, Victoria A.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2020-07-23
Volume
43
Issue
10
Pages
2355-2361
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc20-0348
PMC
PMC7510031
OpenAlex
W3045253019
Cited by
23
References
30
Citations by year
2025: 4 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 10 · 2020: 1
FWCI
3.39
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/content/license (vor, 60 d)
Locations
  • Diabetes Care (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (1R21HD090555)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
Keywords
continuous glucose monitoring, pediatric diabetes, parent-youth dyads, shared decision-making, diabetes technology adoption
MeSH terms
Decision Making, Shared, Glycemic Control, Adolescent, Blood Glucose, Child, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Male, Prognosis, Surveys and Questionnaires, Blood Glucose Self-Monitoring, Self Efficacy

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