Educational Interventions and Predictors of Health Related Quality of Life Among Adolescents with Type 1 Diabetes



Abualula, Nada A

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This dissertation had two objectives: A) determine the optimum diabetes selfmanagement educational (DSME) interventions in improving health-related quality of life (HRQoL) among adolescents with type 1 diabetes (T1D) and describe its characteristics, and B) assess the HRQoL of adolescents with T1D using one self-rated health (SRH) question and identify the most significant factors contributing to lower HRQoL. To address objective (A), a systematic review (SR) of 14 eligible studies was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results showed that the successful interventions provided a combination of direct and indirect behavioral skills or, at the very least, indirect behavioral skills such as stress reduction and coping strategies lasting at least two months. To address objective (B), a sample of adolescents with T1D (n=5,799) from the T1D Exchange Clinic Registry was analyzed. Descriptive statistics showed that those with lower HRQoL whose SRH was "fair" or "poor" (n`0), 62% were female, 59% were aged 16-18 years, 66% had public or no insurance, and 93% had high HbA1c. Logistic regression results showed that the most significant factor associated with lower HRQoL (SRH) among adolescents with T1D is stress. Both the systematic review and secondary data analysis identified stress as important factor in contributing to lowering HRQoL among T1D adolescents. Health care providers and researchers should design optimal DSME interventions that target stress as one of the most important factors associated with lower HRQoL among adolescents with T1D.



Type one diabetes, Adolescents, Health related quality of life, Self rated health, Educational interventions