Telehealth Occupation-Based Coaching for Rural Parents of Children With Type 1 Diabetes: A Randomized Controlled Trial

Abstract

Importance: Because of the complexity of their child’s diabetes management, parents often assume all care duties and report needing additional assistance to resume family routines.Objective: To examine the preliminary efficacy of a telehealth occupation-based coaching intervention for rural parents of a child living with Type 1 diabetes (T1D) to improve child glycemic levels, family quality of life, and parental self-efficacy.Design: Double-blinded, two-arm, pilot randomized controlled trial.Setting: Telehealth video conferencing at home.Participants: 16 dyads of rural parents and children ages 2 to 12 yr diagnosed with T1D.Intervention: Occupation-based coaching delivered through telehealth sessions, once weekly for 12 wk, informed by community partners.Outcomes and Measures: Child measures: hemoglobin A1c and glucose time in range. Family measures: Parenting Sense of Competence, World Health Organization Quality of Life Brief Questionnaire, Goal Attainment Scale, Evidence of Independent Capacity Rating Scale (EICRS), and caregiver talk.Results: Families in the intervention group were more likely to achieve family-centered participation goals ( p 5 .006) than those in the controlled group. Caregiver talk increased significantly over the 12-wk period ( p 5 .034), and the average rating on the EICRS also improved significantly ( p < .001). There were no statistically significant changes in glycemic levels or family quality of life.Conclusions and Relevance: OBC may be more efficacious in helping families to improve health management routines after a child’s diagnosis with T1D than usual endocrinology care alone. Most child health outcomes were in target range at the start of the study; therefore, it was not expected to see significant improvements.