Self-management problem solving for adolescents with type 1 diabetes: intervention processes associated with an Internet program

Objective

Describe intervention processes associated with an Internet self-management problem solving program for adolescents with type 1 diabetes, and relate participant characteristics to program use.

Methods

Forty-one adolescents with type 1 diabetes, aged 13–17, participated in an Internet intervention.

Results

Participants reported psychosocial self-management barriers related to social issues (45%), time pressures (22%), and emotions (25%). Most adolescents (76%) completed the two guided problem solving cycles, and most (97%) problems were appropriate and specific to diabetes. Of the 61 diabetes problems reported, 92% were mostly or completely solved. Baseline hemoglobin A1c, diabetes duration, and age were not related to online activities, however females posted more often to the forum (U = 130.0, Z = 2.13, p = .033). The majority of parents (87%) interacted with their child about the website.

Conclusion

Adolescents experience psychosocial barriers to self-management that can be addressed by teaching problem solving via the Internet.

Practice implications

An Internet self-management problem solving program with minimal external support provides a viable option for diabetes clinics to improve pediatric diabetes outcomes.