Telehealth intervention for adolescents with type 1 diabetes.
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Adolescent↗
Biomedical subjects
Toree Malasanos
Publications and source records attributed to Toree Malasanos.
Knowledge improvement with web-based diabetes education program: brainfood.
BACKGROUND: Health literacy has a direct effect on health outcomes, but the complexity of diabetes education and time constraints on the health care team have made delivery of this education difficult. METHODS: The Florida Initiative in Telemedicine and Education developed an education website (Brainfood) for multiple literacy levels. The site consists of 19 education units, 15 of which provided gradable test scores; a narrated cartoon provides essential information to low reading level learners. Text is presented at both 4th and 10th grade level. Literacy level of the user is not evaluated; rather, users choose their preferred format. The administrative backbone stores user demographics and test scores. Nurses can receive credit hours for completion of Brainfood, 13 tests required. Results were analyzed by a non-paired t test. RESULTS: Five hundred thirteen users have logged in to the site and clicked "I agree" on an informed consent. Of non-nurses, 145 of 389 took pre-tests (range 89-145 depending on module), and 135 took post-tests (range 84-135). For each of the 15 modules, post-test scores improved significantly (P < 0.001 by non-paired t test). Of nurses, 68 of the 124 took pre-tests (range 26-68), and up to 56 (range 24-56) took post-tests. Post-test scores improved significantly (P < 0.05 by non-paired t test) on 13 modules. Post-test scores improved, but were not statistically significant for "Nutrition 101," a module about very basic nutrition. Web-based education about Type 1 diabetes mellitus improved the knowledge level of all users. Nurses had a lower margin of improvement for most modules as they started with a higher base knowledge level. Non-nurses improved significantly on all modules from pre-test to post-test. Post-test scores for the nurses and non-nurses were indistinguishable. CONCLUSION: Brainfood, a web-based diabetes education program, is educationally sound and effective at delivering Type 1 diabetes mellitus education to both professionals and non-professionals. Web access from non-clinic settings can improve access to high-quality education for learners in remote or underserved locations.
Caregivers↗
Home-based behavioral health intervention: Use of a telehealth model to address poor adherence to type-1 diabetes medical regimens.
Youth with insulin-dependent diabetes mellitus face complex treatment regimens and often have difficulty adhering to treatment requirements. Many behavioral-health intervention strategies, such as psychoeducational groups, diabetes summer camps, individual therapy, and residential treatment have been utilized to address this issue. While some have been effective, many barriers exist that limit the number of youth who are able to utilize these treatments. Additionally, the effectiveness of these treatments does not typically generalize to the home environment. Telephone-based, intensive, behavioral-health interventions may address barriers to treatment access by providing lower cost treatment that is easier to access for youth who do not live near a knowledgeable behavioral-health specialist. Additionally, delivery via telephone enables the interventions to take place in the home. This, in combination with parental involvement in the treatment, may increase generalization of the positive treatment outcomes to the home environment. The purpose of this paper is to describe a controlled trial of a telehealth intervention for youth whose diabetes is poorly managed. Preliminary outcome data for the trial are promising. Representative cases from the trial are presented in case-study format.
Adolescent↗
Online diabetes education: design and evaluation with prospective diabetes camp counsellors.
An educational Website was designed by the Florida Initiative in Telehealth and Education group, and an online diabetes education test was developed using a sample of 60 children and young adults aged 8-22 years, all of whom had diabetes. The 31 items were analysed for item difficulty. Eight test items were eliminated as being unsuitable. The test was then used in 67 prospective diabetes counsellors (23 men, 44 women) who volunteered for a summer camp. Camp counsellors ranged in age from 17 to 33 years (mean 22 years, SD 3). The counsellors' mean pre-test scores were 80% and their mean post-test scores were 92%. There was a significant improvement (P=0.001) of approximately 1.25 questions from pre- to post-test. This supports the use of the online educational Website for training individuals working with children with diabetes. The Website may prove to be useful for online education in other areas of diabetes management.
Adolescent↗
An initial evaluation of the design of pediatric psychology consultation service with children with diabetes.
The objective of this study was to review the process of psychology consultation with an outpatient pediatric diabetes service, and provide data regarding assessment and outcome. The purpose was to demonstrate that the inclusion of psychology in the care of the child would enhance the effectiveness of treatment delivery. Over a one-year period, 91 psychological consultations were reviewed for information related to reasons for referral, diagnosis, and treatment. Processes of assessment and collaboration are described. Nearly half of all the participants that were referred for a consultation met the criteria for a psychiatric disorder, including Attention-Deficit Hyperactivity Disorder, mood disorder or anxiety. Paired t-tests revealed significant improvement in metabolic control from referral to the next clinic appointment. Psychological consultation appears to have a positive impact on selected health outcomes. Given the large number of children with psychiatric disorder, psychological intervention may facilitate adherence and reduce complications associated with poor metabolic control.
Adolescent↗
Intensive telehealth management of five at-risk adolescents with diabetes.
Five adolescents with diabetes participated in an intensive outpatient treatment programme designed to improve adherence to their regimen and improve metabolic control. Families reported blood sugar levels, injections and food intake daily by telephone. After four weeks they were offered a video-phone. Nine subjects were recruited but four of them dropped out. Of the remaining five, one subject used a video-phone and one subject reported blood sugar results by email. Most of the children improved their metabolic control and all five subjects showed reduced HbA(1c) levels during the three months of the study. The use of telehealth facilitated the treatment of adolescents with poor glycaemic control.
Adolescent↗