Distressed Families Demonstrate Resilience in the Context of COVID-19: Perspectives of Adolescents With Type 1 Diabetes and Their Mothers.
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ABSTRACT:
SUBMITTER: Goethals ER
PROVIDER: S-EPMC9160532 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
Publications
Distressed Families Demonstrate Resilience in the Context of COVID-19: Perspectives of Adolescents With Type 1 Diabetes and Their Mothers.
Goethals Eveline R ER Bergner Erin M EM Mayberry Lindsay S LS Novak Laurie L LL Erfe Francine F Jaser Sarah S SS
Diabetes spectrum : a publication of the American Diabetes Association 20211118 2
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Project description:ObjectiveResilience processes include modifiable individual and family-based skills and behaviors and are associated with better health and emotional outcomes for youth with Type I diabetes (T1D). There is likely heterogeneity among adolescents with T1D based on differing profiles of resilience processes. At-risk adolescents with lower levels of modifiable skills and assets may benefit more from psychosocial skill-building interventions, compared to adolescents who already have strong resilience processes. This article identified whether there are subgroups of adolescents with T1D based on resilience process profiles and assessed differences in glycemic control, diabetes management behaviors, and distress at baseline. It also evaluated subgroups as moderators of the efficacy of a psychosocial skill-building program.MethodTwo hundred sixty-four adolescents with T1D (14 to 18 years) were randomly assigned to a resilience-promoting program (N = 133) or diabetes education control (N = 131). Data were collected at seven time points over 3 years and analyzed with latent profile analysis and latent growth curve modeling.ResultsThere were two subgroups with high- versus low-resilience processes. The low-resilience subgroup exhibited more distress, higher HbA1c, less glucose monitoring, and fewer diabetes management behaviors at baseline. Differences persisted over 3 years. Subgroup membership did not moderate the efficacy of a resilience-promoting program compared to control. The resilience program resulted in lower distress regardless of subgroup.ConclusionsThere is heterogeneity in resilience process profiles, which are associated with clinically meaningful differences in distress, diabetes management, and glycemic control. Findings can be used to identify at-risk teenagers and inform a targeted approach to care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
| S-EPMC8363191 | biostudies-literature
Project description:Fifty-six children and adolescents with type 1 diabetes at least one year after diagnosis, aged 6-17 years old and fifty-six healthy age- and sex-matched subjects were enrolled in this cross-sectional study. Tear samples were collected using Schirmer strips placed on the lower eyelid. The proteomic analysis was based on a detergent-assisted protein extraction and their digestion from the tears, analysis of the tryptic peptides with LC-MS/ enabling the identification, and quantification of the Shirmer strip protein content via DIA-NN, and subsequently the statistical and bioinformatic analysis using the R and Metascape enrichment analysis tool.
2024-10-17 | PXD052994 | Pride
Project description:PurposeThis study examined how fathers and mothers coparent around child feeding.MethodsFather-mother pairs (N = 30) of preschool-aged children (M child age = 4.1 years old) participated in joint or group interview sessions.ResultsThree themes emerged from the qualitative analysis: (1) couples' division of labor regarding feeding tasks seemed to align with stereotypical gender roles; (2) couples noted that they attempted healthier family eating habits in comparison to families of origin and recognized the influence of extended family on their attempts at healthier feeding; (3) couples agreed on the importance of family mealtime, routines, and healthy meals, yet disagreed on strategies to limit unhealthy foods and achieve harmonious family meals.ConclusionsThis study identified processes of coparenting and child feeding areas that were particularly challenging to manage among parents, which could be important targets for childhood obesity interventions.Level of evidenceV, descriptive study.
| S-EPMC6906266 | biostudies-literature
Project description:ImportanceType 1 diabetes (T1D) requires demanding self-management health behaviors, and adolescents with T1D are at risk for poor psychosocial and medical outcomes. Developing resilience skills may help adolescents with T1D and elevated distress navigate common stressors and achieve positive outcomes.ObjectiveTo test the efficacy of the Promoting Resilience in Stress Management (PRISM) intervention on levels of hemoglobin A1c (HbA1c), diabetes distress, self-management behaviors, resilience, and quality of life among adolescents.Design, setting, and participantsThis phase 3, parallel, 1:1 randomized clinical trial that followed up 172 participants for 12 months was conducted from January 1, 2020, to November 30, 2022, at each of 2 children's hospitals, in Seattle, Washington, and Houston, Texas. Participants were ages 13 to 18 years with T1D for at least 12 months and elevated diabetes distress.InterventionPRISM, a manualized, skills-based, individual intervention program that teaches stress management, goal setting, reframing, and meaning-making, facilitated by a coach and accompanied by a digital app, was delivered in three 30- to 60-minute sessions approximately 2 weeks apart.Main outcomes and measuresThe 2 primary outcomes, diabetes distress and HbA1c levels, and 3 secondary outcomes, resilience, quality of life, and engagement in self-management behaviors, were assessed at baseline and 6 and 12 months after baseline. Linear mixed-effects regression models were used to evaluate associations between PRISM or usual care (UC) and these outcomes at both time points for the intention-to-treat population.ResultsAmong 172 adolescents (mean [SD] age, 15.7 [1.6] years), 96 were female (56%), and their baseline mean (SD) HbA1c level was 8.7% (2.0%). No differences were evident between PRISM and UC recipients in HbA1c levels (β, -0.21 [95% CI, -0.65 to 0.22]; P = .33) or diabetes distress (β, -2.71 [95% CI, -6.31 to 0.90]; P = .14) or any participant-reported outcome (eg, β, 2.25 [95% CI, -0.30 to 4.80]; P = .08 for self-management behaviors) at 6 months. At 12 months, there was no statistically significant difference between arms in HbA1c levels (β, -0.26 [95% CI, -0.72 to 0.19]; P = .25); however, PRISM recipients reported significantly greater amelioration of diabetes distress (β, -4.59 [95% CI, -8.25 to -0.94]; P = .01) and improvement in self-management behaviors (β, 3.4 [95% CI, 0.9 to 5.9]; P = .01) compared with UC recipients.Conclusions and relevanceThe findings in this randomized clinical trial of psychosocial and behavioral improvements associated with PRISM at 12 months illustrate the value of a strengths-based intervention. Integrating resilience skills-building with traditional diabetes care may be a promising approach for improving outcomes among adolescents with T1D and elevated diabetes distress.Trial registrationClinicalTrials.gov number: NCT03847194.
| S-EPMC11333977 | biostudies-literature
Project description:Exclusive breastfeeding (EBF) for the first 6 months of life improves survival, growth and development. In Kenya, recent legislation and policies advocate for maternity leave and workplace support for breastfeeding and breast milk expression. We conducted a qualitative study to describe factors influencing EBF for 6 months among mothers employed in commercial agriculture and tourism. We interviewed employed mothers (n = 42), alternate caregivers and employed mothers' husbands (n = 20), healthcare providers (n = 21), daycare directors (n = 22) and commercial flower farm and hotel managers (n = 16) in Naivasha, Kenya. Despite recognizing the recommended duration for EBF, employed mothers describe the early cessation of EBF in preparation for their return to work. Managers reported supporting mothers through flexible work hours and duties. Yet, few workplaces have lactation spaces, and most considered adjusting schedules more feasible than breastfeeding during work. Managers and healthcare providers believed milk expression could prolong EBF but thought mothers lack experience with pumping. The most frequently suggested interventions for improving EBF duration were to expand schedule flexibility (100% of groups), provide on-site daycare (80% of groups) and workplace lactation rooms (60% of groups), improve milk expression education and increase maternity leave length (60% of groups). Returning to work corresponds with numerous challenges including lack of proximate or on-site childcare and low support for and experience with milk expression. These factors currently make EBF for 6 months unattainable for most mothers in these industries. Interventions and supports to improve breastfeeding upon return to work are recommended to strengthen employed mothers' opportunity for EBF.
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Project description:ObjectivesTo develop and pilot test a program to meet the needs of mothers of adolescents with type 1 diabetes (T1D) and improve outcomes in adolescents with type 1 diabetes.MethodsWe conducted focus groups with mothers of adolescents to identify needs and develop a cognitive behavioral intervention aimed at reducing maternal distress, improving parenting practices, and reducing family conflict. This intervention was pilot tested in a randomized trial; mothers were randomized to either the Coping & Communication (N=15) intervention or Usual Care (N=15). Mothers and adolescents completed questionnaires measuring distress, parenting, and family conflict pre- and post-intervention, and HbA1c values were obtained from adolescents' medical records pre- and post-intervention.ResultsIntervention materials (Communication & Coping) received high scores on health literacy and engagement. There was a significant Time × Group interaction for maternal diabetes distress, family conflict (as reported by both mothers and adolescents) and adolescent quality of life. Mothers and adolescents randomized to the intervention group reported significant improvements on these factors as compared to those randomized to usual care.ConclusionsThe Communication & Coping program was developed by adapting existing interventions proven to reduce depressive symptoms and improve parenting practices to address the specific needs of mothers of adolescents with T1D. The program shows promise for not only reducing distress in mothers, but also for improving adolescent outcomes, possibly through reductions in family conflict.
| S-EPMC6193460 | biostudies-literature
Project description:Marine heatwaves are becoming more frequent during summer and pose a significant threat to coral reef ecosystems. Restoration efforts have the potential to support native coral populations and guard them against some degree of environmental change, while global action against climate change takes place. Interspecific hybridization is one approach through which resilient coral stock could be generated for restoration. Here we compared the performance of Acropora kenti and A. loripes hybrid and purebred coral recruits under a simulated thermal stress event. A. kenti eggs were successfully fertilized by A. loripes sperm to produce 'KL' hybrids, but no 'LK' hybrids could be produced from A. loripes eggs and A. kenti sperm. Despite corals in the elevated treatment accruing thermal stress (>12 degree heating weeks over 2 months) known to result in mass bleaching, both purebred and hybrid recruits showed no signs of stress under the simulated temperature regime, based on the performance indicators survivorship, size, color (a proxy of bleaching), and photochemical efficiency of photosystem II. Comparisons between the hybrids and purebreds studied here must be interpreted with caution because hybrid sample sizes were small. The hybrids did not outperform both of their purebred counterparts for any metrics studied here, demonstrating that there are limitations to the extent to which interspecific hybridization may boost the performance of coral stock. In general, the purebred A. loripes recruits performed best under both ambient and elevated conditions. The performance of the KL hybrid corals was similar to the maternal parental species, A. kenti, or not significantly different to either parental purebred species. The Symbiodiniaceae communities of the KL hybrids were characteristic of their maternal counterparts and may have underpinned the performance differences between the A. kenti/KL hybrid and A. loripes recruits.
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Project description:The complex milieu of inflammatory mediators associated with many diseases is often too dilute to directly measure in the periphery, necessitating development of more sensitive measurements suitable for mechanistic studies, earlier diagnosis, guiding selection of therapy, and monitoring interventions. Previously, we determined that plasma of recent-onset (RO) Type 1 diabetes (T1D) patients induce a proinflammatory transcriptional signature in fresh peripheral blood mononuclear cells (PBMC) relative to that of unrelated healthy controls (HC). Here, using an optimized cryopreserved PBMC-based protocol, we analyzed larger RO T1D, HC, and healthy T1D sibling cohorts. In addition, we examined T1D progression by looking at longitudinal samples.
2014-05-13 | GSE52724 | GEO
Project description:IntroductionDigital health intervention offers the potential to enhance health literacy, which is crucial for effective diabetes management, especially among adolescents. Diabetes is a major global public health issue, leading to devastating complications and increasing mortality rates. The incidence of type 1 diabetes mellitus (T1DM) is also on the rise, particularly among adolescents, necessitating multisectoral strategies to combat this disease. This study explores the perceptions of adolescents with T1DM in Germany regarding digital health interventions, with the aim of improving healthcare by addressing specific needs and guiding future research.MethodologyThis study employed a qualitative approach using semi-structured individual interviews with adolescents with T1DM (n = 20) aged 14 to 18 years old in Germany to explore their perspectives on digital interventions for health literacy promotion. The study adopted content analysis according to Kuckartz et al. and the research followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Ethical considerations were paramount and data were rigorously analyzed using coding and iterative processes to ensure data quality and reliability.ResultsThe findings indicate that within three prominent domains, namely the utilization of digital health intervention for accessing and comprehending information, facilitating peer-to-peer interactions, and enhancing physician-patient communication and interaction, digital health interventions are either underutilized or insufficiently deployed. In addition, a notable observation is the apparent lack of patient-centered approaches for adolescents with T1DM in relation to digital health interventions and health literacy.ConclusionIn order to enhance the utilization of digital health interventions and enhance health literacy it is essential to focus on capacity building through a patient-centered approach, to promote digital health literacy, and foster the cultivation of a participatory culture. The outcomes of this study offer valuable insights that can inform practical applications, further research endeavors, and influence policymaking.
| S-EPMC10896973 | biostudies-literature
Project description:The complex milieu of inflammatory mediators associated with many diseases is often too dilute to directly measure in the periphery, necessitating development of more sensitive measurements suitable for mechanistic studies, earlier diagnosis, guiding selection of therapy, and monitoring interventions. Previously, we determined that plasma of recent-onset (RO) Type 1 diabetes (T1D) patients induce a proinflammatory transcriptional signature in fresh peripheral blood mononuclear cells (PBMC) relative to that of unrelated healthy controls (HC). Here, using an optimized cryopreserved PBMC-based protocol, we analyzed larger RO T1D, HC, and healthy T1D sibling cohorts. In addition, we examined T1D progression by looking at longitudinal samples. UPN727 cells were stimulated with Auto-antibody-negative (AA-) High HLA Risk Siblings plasma (n=30), Auto-antibody-negative (AA-) Low HLA Risk Siblings plasma (n=42), Recent onset T1DM plasma cultured with IL1RA (n=42), or longitudinal series plasma on T1DM progressor (n=27 chips, 5 series), on auto-antibody-positive (AA+) High HLA Risk Siblings (n=54 chips, 9 series), on auto-antibody-negative (AA-) High HLA Risk Siblings (n=60 chips, 12 series), on auto-antibody-negative (AA-) Low HLA Risk Siblings (n=31 chips, 6 series). Gene expression analysis was perfromed in order to evaluate the transcriptional signature associated with T1D.
2014-05-13 | E-GEOD-52724 | biostudies-arrayexpress