REAL-Fam Feasibility Study for Youth Diabetes Management

University of North Carolina (UNC)

Status: Not yet enrolling

Conditions: Type 1 Diabetes

Treatments: Behavioral: REAL-Fam Occupational Therapy Family Coaching

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT07212790

25-0708

Details and patient eligibility

About

The goal of this clinical trial is to learn if the REAL-Fam occupational therapy intervention is feasible to study in a larger-scale randomized controlled trial. It will also seek to understand how the intervention influences how a rural family participates in and manages their child's type 1 diabetes, their family quality of life, and the child's health outcomes. The main questions it aims to answer are:

• Primary Aim 1: Evaluate the recruitment capability, participant inclusion criteria, assessment selection and process, and data.
• Primary Aim 2: Evaluate the participant acceptability of and interventionist fidelity to the intervention.
• Secondary Aim: Evaluate families' preliminary outcomes to the REAL-Fam on family quality of life and participation, diabetes management self-efficacy, and child blood glucose stability.

Researchers will compare the REAL-Fam intervention to the Attention Group to see if there are changes in family diabetes-related health routines and psychosocial aspects of managing a child's type 1 diabetes.

Participants will:

• Children will wear continuous glucose monitors for study period
• Caregiver participants will complete baseline and post-intervention surveys
• Intervention Group: engage in 12 audio/video telehealth sessions with REAL-Fam intervention
• Attention Group: engage in 3 audio/video Zoom meetings without specialized services
• Complete a post-study interview

Full description

The prevalence of type 1 diabetes (T1D) is increasing among youth in the U.S., with higher incidence rates documented in rural communities compared to their urban peers. This rise is especially concerning for rural families, because they are at risk for healthcare disparities resulting from transportation challenges, lack of healthcare access, decreased financial stability, and other social determinants of health. The Resilient Empowered Active Living for Families (REAL-Fam) occupational therapy telehealth intervention provides a practical, immediate solution to increase access to low-cost, quality healthcare services for rural-dwelling caregivers and children living with T1D. Utilizing community-engaged research methods, this randomized clinical trial with follow-up interviews examines the feasibility of the 12-week REAL-Fam intervention group (n=8 dyads) compared to an attention group (n=8 dyads) for rural-dwelling caregiver/child dyads to improve the a) caregivers' diabetes management self-efficacy, b) caregivers' quality of life, and the c) children's glycemic levels. The REAL-Fam is innovative because it will extend diabetes care beyond glucose monitoring to include culturally sensitive healthcare experiences, family-centered behavioral interventions, healthy habit and routine training, and school and childcare participation strategies within the scope of occupational therapy. The successful evaluation of the REAL-Fam is critical to evaluate the protocol and support a full-scale clinical trial, which may inform other historically underrepresented socio-demographic groups that may not have access to ongoing diabetes healthcare services.

The findings from this study will inform healthcare practitioners, patients, and other stakeholders of the needs of rural families who are caring for a child with T1D and their urgent healthcare needs, such as improving quality of life and increasing access to specialized healthcare services. From the interdisciplinary team's past research focusing on T1D stakeholder needs in rural communities, it was apparent that many caregivers reported a need to access specialized diabetes care quicker after their child's diagnosis, which without this access they experienced poor health outcomes. Overall, successful evaluation of the REAL-Fam telehealth intervention is an important, necessary step to support future studies that may contribute to the advancement of T1D healthcare practices and improved child health outcomes for rural dwelling families.

Enrollment: 16 estimated patients

Sex: All

Ages: 2 to 99 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Caregiver over 19 years old and designated guardian or parent to a child living with Type 1 Diabetes;
• Live in a rural area over 1 hour from pediatric endocrinology care team;
• Access to reliable internet

Exclusion criteria

• Caregiver who is not completing any supervision/support for their child's diabetes management;
• If the child is currently receiving occupational therapy services;
• Has a severe developmental, intellectual, or neurological disability

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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16 participants in 2 patient groups

REAL-Fam Intervention Group

Experimental group

Description:

8 caregiver-child dyads will receive the Resilient, Empowered, Active Living for Families intervention. This is an occupational therapy family coaching intervention, which will be delivered via 12 weekly telehealth sessions.

Treatment:

Behavioral: REAL-Fam Occupational Therapy Family Coaching

Attention Group

No Intervention group

Description:

8 caregiver-child dyads will receive 3 attention group sessions with a research team member and engage in activities such as creating music play lists, playing games, and having conversation without specialized healthcare services.