Diabetes Strengths Study - Pilot of Provider-delivered Strengths-based Intervention

The purpose of this study is to pilot test a newly developed strengths-based clinical
intervention delivered by diabetes care providers in the context of routine ambulatory
diabetes care, designed to promote resilience and support diabetes management among
adolescents with type 1 diabetes and their families. The emphasis of the intervention is
shifting the tone of clinical encounters for diabetes care to emphasize and reinforce youths'
and families' current diabetes strengths and positive diabetes management behaviors. Youth
with type 1 diabetes are seen routinely in clinic every 3-4 months, and this intervention
will occur at two consecutive clinic visits. The intervention consists of (A) assessing youth
and family diabetes strengths and adherence prior to each visit, and (B) training diabetes
care providers to tailor their clinical encounters around reinforcing each patient and
family's unique "diabetes strengths profile" generated from the strengths and adherence
assessments.

Outcome assessments are conducted at baseline (prior to the start of the intervention) and
immediately following the conclusion of the intervention (approximately 6-8 months later).
The primary outcome is feasibility and acceptability, measured by qualitative feedback from
participants and providers, as well as quantification of recruitment and enrollment, provider
adherence to intervention protocol, and time to completion. Secondary (exploratory) outcomes
include diabetes regimen adherence, glycemic control, family conflict, diabetes burden,
diabetes strengths, and satisfaction with the diabetes care provider relationship. Strengths
and adherence assessments are also completed prior to the second clinic visit to generate the
diabetes strengths profile.

Inclusion Criteria:

1. At least one parent of each adolescent, self-identified as the primary caregiver most
involved in diabetes care, will also be enrolled with each adolescent participant.
When present, secondary caregivers involved in diabetes management will be invited
(not required) to participate.

2. Youth type 1 diabetes diagnosis for at least 12 months, to allow ample opportunity for
adjustment to diabetes management

3. Youth and parent fluency in written and spoken English because assessment measures are
not available in other languages.

Exclusion Criteria:

(1) Presence of a serious mental illness or developmental disability in youth or parent
that would impede participation would exclude eligibility.