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Youth Involvement in the Decision to Start CGM Predicts Subsequent CGM Use.
Miller, Victoria A; Xiao, Rui; Slick, Nathalie; Feudtner, Chris; Willi, Steven M.
Afiliação
  • Miller VA; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA millerv@email.chop.edu.
  • Xiao R; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Slick N; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.
  • Feudtner C; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Willi SM; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.
Diabetes Care ; 43(10): 2355-2361, 2020 10.
Article em En | MEDLINE | ID: mdl-32703764
OBJECTIVE: The ability of continuous glucose monitoring (CGM) to improve diabetes outcomes depends upon consistent use. To identify factors that facilitate long-term use of CGM, this study tested the hypothesis that youth involvement in the decision to initiate this therapy would influence subsequent CGM use and that CGM self-efficacy and satisfaction mediate this relationship. RESEARCH DESIGN AND METHODS: Before initiating CGM, parent-youth dyads (i.e., pairs) from an academic endocrinology clinic completed assessments, including a measure of the child's involvement in the decision to start CGM. Two months into CGM use, youth completed measures of CGM self-efficacy and satisfaction. Fidelity of CGM use between weeks 5 and 12 was accessed via a cloud-based data repository. Hypotheses were tested with linear mixed-effects models, accounting for patients clustered within provider and repeated measures within patients. RESULTS: CGM use in 108 dyads (youth mean age 13.4 ± 2.7 years; 73% White) was positively predicted by baseline parent report of youth involvement in the CGM decision (P < 0.0001), and this relationship was mediated by youth's perceptions of CGM self-efficacy (P < 0.0001) and hassle (P = 0.014). So, when the youth shared their opinions about CGM with parents and participated in the decision to start, they perceived higher self-efficacy and lower hassle at 2-month follow-up, which predicted more days of use. This pattern held in models adjusting for youth race and sex and family income. CONCLUSIONS: To achieve maximum clinical benefit from CGM use, providers should facilitate youth involvement in the decision to initiate the device.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Autoeficácia / Diabetes Mellitus Tipo 1 / Tomada de Decisão Compartilhada / Controle Glicêmico Tipo de estudo: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Diabetes Care Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Autoeficácia / Diabetes Mellitus Tipo 1 / Tomada de Decisão Compartilhada / Controle Glicêmico Tipo de estudo: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Diabetes Care Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos