Behavioral interventions for adolescents with type 1 diabetes: How effective are they?
Abstract
OBJECTIVE: To evaluate the effectiveness of behavioral interventions for adolescents with type 1 diabetes based on a systematic review of the literature. RESEARCH DESIGN AND METHODS: The literature was identified by searching 11 electronic databases, hand-searching 3 journals from their start dates, and contacting individual researchers. Only articles that reported evaluations of behavioral (including educational and psychosocial) interventions for adolescents (age range 9-21 years) with type 1 diabetes that included a control group were included in the present review. Data summarizing the key features of the interventions and their effects were extracted from each article. Where possible, effect sizes for the randomized control trials (RCTs) were calculated. RESULTS: The search process identified 64 reports of empirical studies. Of these, 35 studies included a control group, and 24 were RCTs. Effect sizes could be calculated for 18 interventions. The overall mean effect size calculated across all outcomes was 0.33 (median 0.21), indicating that these interventions have a small- to medium-sized beneficial effect on diabetes management. Interventions that were theoretically based were significantly more effective than those that were not (P<0.05, 1-tailed). CONCLUSIONS: Research to date indicates that these interventions are moderately effective. Several methodological weaknesses to be avoided in future studies are noted. It is also recommended that investigators use the reach, efficacy, adoption, implementation, and maintenance (RE-AIM) framework to guide the design of future studies, which should result in more disseminable interventions. RE-AIM assesses the intervention's reach, or percent or representativeness of patients willing to participate; efficacy across a range of outcomes; adoption, or the percent and representativeness of settings willing to implement the intervention; implementation, or the consistency of the delivery of the intervention as intended; and maintenance, or the extent to which delivery of the intervention becomes a routine part of health care in the medical setting.
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The negative result for child HbA1c aligns with past research which has sometimes shown a more robust response for psychosocial versus glycemic outcomes following behavioral interventions in persons with type 1 diabetes.
“However, this negative result also aligns with past research which has sometimes shown a more robust response for psychosocial versus glycemic outcomes following behavioral interventions in persons with type 1 diabetes [30].”
From A nonrandomized pilot of a group, video-based telehealth intervention to reduce diabetes distress in parents of youth with type 1 diabetes mellitus (2022) · cites this paper as [30]
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“…behavioral interventions are generally effective at improving medical adherence and glycemic control in youth with diabetes (Delamater et al., 2001; Hampson et al., 2000), with both family-based and peergroup interventions showing positive outcomes (B. J. Anderson, Wolf, Burkhart, Cornell, &…”
BackgroundEiser, C., Johnson, B., Brierley, S., Ayling, K., Young, V., Bottrell, K., Whitehead, V., Elliott, D., Scott, A., & Heller, S. R. (2013) · Diabetic Medicine · doi:10.1111/dme.12185 · Cited by 14 · see citing works
Olley, B. O., Abbas, M., & Gidron, Y. (2011) · SAHARA-J Journal of Social Aspects of HIV/AIDS · doi:10.1080/17290376.2011.9724981 · Cited by 14 · see citing works
“Studies in other health domains such as diabetes have shown that interventions based on psychological models of health behaviour are more effective than non-theoretically based interventions (Hampson et al., 2000).”
Dunkel, A., von Storch, K., Hochheim, M., Zank, S., Polidori, M. C., & Woopen, C. (2024) · International Journal of Behavioral Medicine · doi:10.1007/s12529-024-10323-0 · Cited by 13 · see citing works
Plante, W. A., & Lobato, D. J. (2008) · Children s Health Care · doi:10.1080/02739610701601361 · Cited by 12 · see citing works
“Whereas Hampson et al. (2000) reviewed individual and group behavioral interventions for patients aged 9 to 21 years old, we describe an additional 15 group treatments that were not included in their review, 6 of which were published in 2000 or more recently.”
BackgroundResultInfluentialKassaï, B., Rabilloud, M., Bernoux, D., Michal, C., Riche, B., Ginhoux, T., Laudy, V., Terral, D., Didier-Wright, C., Maire, V., et al. (2015) · Trials · doi:10.1186/s13063-015-0923-7 · Cited by 12 · see citing works
Gelernter, R., Lavy, G., Yanai, L., Brooks, R., Bar, Y., Bistrizer, Z., & Rachmiel, M. (2015) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2015-0150 · Cited by 11 · see citing works
Noyes, J. P., Lowes, L., Whitaker, R., Allen, D. A., Carter, C., Edwards, R. T., Rycroft‐Malone, J., Sharp, J., Edwards, D. J., Spencer, L. H., et al. (2014) · Health Services and Delivery Research · doi:10.3310/hsdr02080 · Cited by 11 · see citing works
Psychological Factors and Diabetes Mellitus
Pouwer, F., & Speight, J. (2016) · Wiley eBooks · doi:10.1002/9781118924853.ch56 · Cited by 12 · see citing works
Design of a trial of Internet-based self-management for diabetes
Armstrong, N., powell, J. A., Hearnshaw, H., et al. (2007) · Journal of Telemedicine and Telecare · doi:10.1258/135763307781645220 · Cited by 10 · see citing works
Dye, A. M., Alemzadeh, R., Wang, J., Tolley, E. A., & Lahoti, A. (2021) · Journal of the National Medical Association · doi:10.1016/j.jnma.2021.10.001 · Cited by 8 · see citing works
Anxiety Disorders in Children with Chronic Health Problems
Farrell, L. J., Donovan, C. L., Turner, C. M., & Walker, J. R. (2011) · Springer eBooks · doi:10.1007/978-1-4419-7784-7_32 · Cited by 8 · see citing works
Parenting interventions for parents of children with type 1 diabetes—a systematic review
Jansen, M., Voorhoeve, P. G., Wiltink, L., Prins, J. B., & Nefs, G. (2025) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsaf078 · Cited by 7 · see citing works
“Our results suggest that for proper intervention evaluation, psychosocial endpoints need to be considered alongside medical criteria such as HbA1c (Feldman et al., 2018; Hampson et al., 2000), using appropriate and updated diabetes-specific measures of family behavior.”
유다선, & Son, C. (2014) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2014.19.3.001 · Cited by 5 · see citing works
- Authors
- Hampson, S. E., Skinner, T. C., Hart, J., Storey, L., Gage, H., Foxcroft, D., Kimber, A., Cradock, S., & McEvilly, E. A.
- Affiliations
- University of Surrey (GB)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2000-09-01
- Volume
- 23
- Issue
- 9
- Pages
- 1416-1422
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1982725668
- Cited by
- 134
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 6 · 2019: 8 · 2018: 3 · 2017: 1 · 2016: 7 · 2015: 9 · 2014: 11 · 2013: 9 · 2012: 2
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Open Research (University of Surrey) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Figshare (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Diabetes Care
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- type 1 diabetes, adolescents, behavioral interventions, diabetes self-management, psychosocial interventions, educational intervention, intervention effectiveness, theory-based intervention, RE-AIM framework, intervention dissemination
- MeSH terms
- Adolescent, Psychology, Adolescent, Adult, Behavior Therapy, Child, Diabetes Mellitus, Type 1, Humans, Periodicals as Topic, Databases, Bibliographic
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