Education and Telephone Case Management for Children With Type 1 Diabetes: A Randomized Controlled Trial

• Published in: Journal of pediatric nursing Vol. 20; no. 2; pp. 83 - 95
• Main Authors: Howe, Carol J., Jawad, Abbas F., Tuttle, Alan K., Moser, Joanne T., Preis, Christina, Buzby, Marianne, Murphy, Kathryn M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2005
• Subjects: Adolescent; Analysis of Variance; Case Management - organization & administration; Child; Child, Preschool; Cooperative Behavior; Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 1 - nursing; Diabetes Mellitus, Type 1 - prevention & control; Educational Measurement; Female; Glycated Hemoglobin A - metabolism; Humans; Male; Nursing; Nursing Evaluation Research; Outcome Assessment (Health Care); Parent-Child Relations; Patient Compliance - psychology; Patient Education as Topic - organization & administration; Pediatric Nursing - organization & administration; Philadelphia; Program Evaluation; Self Care - psychology; Surveys and Questionnaires; Telephone
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2004.12.010

The purpose of the study was to compare three nursing interventions and their impact on glycemic control among children with type I diabetes. The 75 subjects' mean ±
SD age was 12.5 ± 3.4 years, 55% were boys, and 55% were White. Subjects were randomly assigned to a standard care (SC), an education (ED), or an education and telephone case management (ED + TCM) group. The primary outcome measure was glycemic control (hemoglobin A1c, or HbA1c). Secondary outcome measures were diabetes knowledge (KNOW), parent–child teamwork (TEAM), and adherence (ADH). After 6 months of follow-up, results demonstrated no significant differences among groups in HbA1c. KNOW and TEAM scores improved slightly in the ED and ED + TCM groups, but no statistically significant differences were found among the three groups. Significant improvement in ADH scores among ED + TCM groups was reported when compared with the ED and SC groups. This change may represent a move toward improved adherence to diabetes care and subsequent improvement in diabetes control. The challenges of recruitment and retention of subjects in this study will also be discussed.