PETS-D

Impact on Diabetes Management Outcomes

Susan Sullivan-Bolyai, Sybil Crawford, Carol Bova, Mary Lee, J. B. Quintos, Kim Johnson, Karen Cullen, Terri Hamm, Jean Bisordi, Neesha Ramchandani, Jason Fletcher, Diane Quinn, Carol Jaffarian, Terri Lipman, Gail D'Eramo Melkus

Research output: Contribution to journalArticle

Abstract

Objective To evaluate the efficacy of Parent Education Through Simulation–Diabetes (PETS-D; clinical trial registration NCT01517269) for parents of children <13 years old newly diagnosed with type 1 diabetes with 3 parent education vignette sessions using human patient simulation (HPS) as compared with formal parent-nurse education sessions (vignette only) regarding diabetes knowledge, problem-solving skills, hypoglycemia fear, anxiety, and self-efficacy. Design and Methods Subjects were randomized to the HPS parent diabetes education or the vignette-only arm. Using linear mixed modeling, we compared HPS and vignette-only groups at 2, 6, and 14 weeks. Effect modification of treatment by dichotomized child’s age (<6 and ≥6 years old) and parent education (≤high school and >high school) was also tested. All analyses were intent to treat and adjusted for baseline outcome level and clustering within site. Results We recruited 191 parents (116 children). Mean baseline A1C was 12%. Overall treatment-related differences were modest. There was a statistically significant effect modification of HPS by child’s age, with a larger HPS benefit among parents of younger children for several outcomes: A1C (8.16% vs 9.48% in control; P =.006), lower state anxiety (P =.0094), and higher fear of hypoglycemia (P =.03) for parents of children <6 years old in the HPS group. Conclusions Modest treatment-related differences may reflect ceiling/floor effects in many of the outcomes; we also compared HPS with another intervention rather than to usual education. Parents of younger children receiving the intervention may feel more comfortable with lower A1C levels because of management awareness gleaned from the HPS experience. Future research will include a retrospective case-control study of very young children.

Original languageEnglish (US)
Pages (from-to)537-549
Number of pages13
JournalDiabetes Educator
Volume41
Issue number5
DOIs
StatePublished - Oct 24 2015

Fingerprint

Parents
Education
Hypoglycemia
Fear
Cluster Analysis
Case-Control Studies
Anxiety
Clinical Trials
Therapeutics

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Health Professions (miscellaneous)

Cite this

Sullivan-Bolyai, S., Crawford, S., Bova, C., Lee, M., Quintos, J. B., Johnson, K., ... D'Eramo Melkus, G. (2015). PETS-D: Impact on Diabetes Management Outcomes. Diabetes Educator, 41(5), 537-549. https://doi.org/10.1177/0145721715598383

PETS-D : Impact on Diabetes Management Outcomes. / Sullivan-Bolyai, Susan; Crawford, Sybil; Bova, Carol; Lee, Mary; Quintos, J. B.; Johnson, Kim; Cullen, Karen; Hamm, Terri; Bisordi, Jean; Ramchandani, Neesha; Fletcher, Jason; Quinn, Diane; Jaffarian, Carol; Lipman, Terri; D'Eramo Melkus, Gail.

In: Diabetes Educator, Vol. 41, No. 5, 24.10.2015, p. 537-549.

Research output: Contribution to journalArticle

Sullivan-Bolyai, S, Crawford, S, Bova, C, Lee, M, Quintos, JB, Johnson, K, Cullen, K, Hamm, T, Bisordi, J, Ramchandani, N, Fletcher, J, Quinn, D, Jaffarian, C, Lipman, T & D'Eramo Melkus, G 2015, 'PETS-D: Impact on Diabetes Management Outcomes', Diabetes Educator, vol. 41, no. 5, pp. 537-549. https://doi.org/10.1177/0145721715598383
Sullivan-Bolyai S, Crawford S, Bova C, Lee M, Quintos JB, Johnson K et al. PETS-D: Impact on Diabetes Management Outcomes. Diabetes Educator. 2015 Oct 24;41(5):537-549. https://doi.org/10.1177/0145721715598383
Sullivan-Bolyai, Susan ; Crawford, Sybil ; Bova, Carol ; Lee, Mary ; Quintos, J. B. ; Johnson, Kim ; Cullen, Karen ; Hamm, Terri ; Bisordi, Jean ; Ramchandani, Neesha ; Fletcher, Jason ; Quinn, Diane ; Jaffarian, Carol ; Lipman, Terri ; D'Eramo Melkus, Gail. / PETS-D : Impact on Diabetes Management Outcomes. In: Diabetes Educator. 2015 ; Vol. 41, No. 5. pp. 537-549.
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abstract = "Objective To evaluate the efficacy of Parent Education Through Simulation–Diabetes (PETS-D; clinical trial registration NCT01517269) for parents of children <13 years old newly diagnosed with type 1 diabetes with 3 parent education vignette sessions using human patient simulation (HPS) as compared with formal parent-nurse education sessions (vignette only) regarding diabetes knowledge, problem-solving skills, hypoglycemia fear, anxiety, and self-efficacy. Design and Methods Subjects were randomized to the HPS parent diabetes education or the vignette-only arm. Using linear mixed modeling, we compared HPS and vignette-only groups at 2, 6, and 14 weeks. Effect modification of treatment by dichotomized child’s age (<6 and ≥6 years old) and parent education (≤high school and >high school) was also tested. All analyses were intent to treat and adjusted for baseline outcome level and clustering within site. Results We recruited 191 parents (116 children). Mean baseline A1C was 12{\%}. Overall treatment-related differences were modest. There was a statistically significant effect modification of HPS by child’s age, with a larger HPS benefit among parents of younger children for several outcomes: A1C (8.16{\%} vs 9.48{\%} in control; P =.006), lower state anxiety (P =.0094), and higher fear of hypoglycemia (P =.03) for parents of children <6 years old in the HPS group. Conclusions Modest treatment-related differences may reflect ceiling/floor effects in many of the outcomes; we also compared HPS with another intervention rather than to usual education. Parents of younger children receiving the intervention may feel more comfortable with lower A1C levels because of management awareness gleaned from the HPS experience. Future research will include a retrospective case-control study of very young children.",
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AU - Cullen, Karen

AU - Hamm, Terri

AU - Bisordi, Jean

AU - Ramchandani, Neesha

AU - Fletcher, Jason

AU - Quinn, Diane

AU - Jaffarian, Carol

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N2 - Objective To evaluate the efficacy of Parent Education Through Simulation–Diabetes (PETS-D; clinical trial registration NCT01517269) for parents of children <13 years old newly diagnosed with type 1 diabetes with 3 parent education vignette sessions using human patient simulation (HPS) as compared with formal parent-nurse education sessions (vignette only) regarding diabetes knowledge, problem-solving skills, hypoglycemia fear, anxiety, and self-efficacy. Design and Methods Subjects were randomized to the HPS parent diabetes education or the vignette-only arm. Using linear mixed modeling, we compared HPS and vignette-only groups at 2, 6, and 14 weeks. Effect modification of treatment by dichotomized child’s age (<6 and ≥6 years old) and parent education (≤high school and >high school) was also tested. All analyses were intent to treat and adjusted for baseline outcome level and clustering within site. Results We recruited 191 parents (116 children). Mean baseline A1C was 12%. Overall treatment-related differences were modest. There was a statistically significant effect modification of HPS by child’s age, with a larger HPS benefit among parents of younger children for several outcomes: A1C (8.16% vs 9.48% in control; P =.006), lower state anxiety (P =.0094), and higher fear of hypoglycemia (P =.03) for parents of children <6 years old in the HPS group. Conclusions Modest treatment-related differences may reflect ceiling/floor effects in many of the outcomes; we also compared HPS with another intervention rather than to usual education. Parents of younger children receiving the intervention may feel more comfortable with lower A1C levels because of management awareness gleaned from the HPS experience. Future research will include a retrospective case-control study of very young children.

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