Abstract Body

Parents of young children with type 1 diabetes (<7 years-old) commonly report at least moderate levels of hypoglycemia fear, which may negatively impact their quality of life and management of their child’s diabetes. To help treat parents’ fear, we designed a group-based behavioral intervention ready for delivery via direct-to-home video-based telehealth. Our intervention, called Reducing Emotional Distress for Child Hypoglycemia in Parents (REDCHiP), teaches parents cognitive-behavioral strategies, behavioral parenting strategies, and new coping methods to help reduce their fear of child hypoglycemia. To date, we have tested our REDCHiP intervention in a pilot study that recruited 42 parents. We randomized parents to one of two groups. Parents randomized to the active treatment condition received REDCHiP at study enrollment (n=22), while parents randomized to a wait list control (n=21) condition eventually had the option of receiving the REDCHiP intervention after they had completed the wait list period.

In our pilot, 97.6% of parents described themselves as the mother. Parents' mean age was 35.2 years (SD=5.0 years). Young children’s mean age was 4.4 years (SD=1.4 years) and 59.5% were boys. Comparing post-treatment scores, parents receiving REDCHiP as part of the active treatment condition reported a significant reduction in hypoglycemia fear (p=0.04) compared to wait list parents. Parents who received REDCHiP as part of the active treatment condition also reported significant reductions in hypoglycemia fear and parenting stress (p’s<0.01) compared to their pre-treatment levels after a three-month maintenance period. Finally, all parents receiving REDCHiP (n=36) reported significant reductions in hypoglycemia fear and parenting stress (p’s<0.001), and in sensitivity analyses, we observed a significant reduction in glycated hemoglobin (p< 0.05) among young children with pre-treatment levels above 58 mmol/mol (>7.5%).

Preliminary results from our pilot trial of REDCHiP suggest that it may be feasible and acceptable to reduce parent’s hypoglycemia fear via cognitive-behavioral therapy and direct-to-home video-based telehealth. A larger efficacy trial of REDCHiP is now underway to confirm these preliminary results. This trial will recruit families from multiple diabetes centers to enhance generalizability of the results and to provide a platform for developing and testing novel strategies to enhance future implementation of the REDCHiP intervention and its direct-to-home video-based telehealth delivery method.