The purposes of this paper are to (1) review the literature on educational interventions for children and adolescents; (2) determine what kinds of interventions have been studied, how effective they are, and their outcomes; and (3) develop recommendations for further research in the field.
METHODS
An integrative literature review approach was used. Articles were included in this review if they met the criteria of being an empirical study reporting results of an intervention whose primary subjects were children with type 1 diabetes and/or their families, and published between 1980 and January 1, 1999. Of the 59 articles identified, 41 met these criteria.
RESULTS
The majority of the studies focused on adolescents. Results suggested that traditional educational interventions are successful in increasing knowledge but less successful in increasing quality of life or improving metabolic control. Psychosocial and family interventions (coping skills training) have been more successful in both quality-of-life and metabolic outcomes.
CONCLUSIONS
There is much work to be done to strengthen our understanding of what works under what conditions. More studies of younger children, minority youth, and families are needed using wellcontrolled experimental designs with adequate samples.
Get full access to this article
View all access options for this article.
References
1.
1. Brown SA. Studies of educational interventions and outcomes in diabetic adults: a meta-analysis revisited. Patient Educ Couns. 1990;16: 189-215.
2.
2. Padgett D, Mumford E, Hynes M, Carter R. Meta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitus. J Clin Epidemiol. 1988;41:1007-1030.
3.
3. Brandt P. Childhood diabetes: behavioral research. In: Fitzpatrick JJ, ed. Annual Review of Nursing Research. New York: Springer; 1998:63-82.
4.
4. Erikson EH. Identity: Youth and Crisis. New York: WW Norton; 1968.
5.
5. Piaget J. The Origins of Intelligence in Children. New York: International Universities; 1952.
6.
6. Wolanski R, Sigman T, Polychonakos C. Assessment of blood glucose monitoring skills in a camp for diabetic children: the effects of individualized feedback counseling. Patient Educ Couns. 1996;29: 5-11.
7.
7. Shobhana R, Rao R, Vijay V, Snehalatha C, Ramachandran A. Diabetes education session for young IDDM probands and their family members in a developing country: an evaluation. Practical Diabetes Int. 1997;14: 123-125.
8.
8. Huttunen N, Lankela S, Knip M, et al. Effect of a once-aweek training program on physical fitness and metabolic control in children with IDDM. Diabetes Care. 1989;12: 737-740.
9.
9. Drozda DJ, Dawson VA, Long DJ, Freson LS, Sperling MA. Assessment of the effect of a comprehensive diabetes management program on hospital admission rates of children with diabetes mellitus. Diabetes Educ. 1990;16:389-393.
10.
10. Delamater AM, Bubb J, Davis SG, et al. Randomized, prospective study of self-management training with newly diagnosed diabetic children. Diabetes Care. 1990;13: 492-498.
11.
11. Pichert JW, Snyder GM, Kinzer CK, Boswell EJ. Sydney meets the ketone challenge-a videodisc for teaching diabetes sick-day management through problem solving. Diabetes Educ. 1992;1 8:476-477.
12.
12. Pichert JW, Meek JM, Schlundt DG, et al. Impact of anchored instruction on problem-solving strategies of adolescents with diabetes. J Am Diet Assoc. 1994;94: 1036-1038.
13.
13. Pichert JW, Snyder GM, Kinzer CK, Boswell EJ. Problem-solving anchored instruction about sick days for adolescents with diabetes. Patient Educ Couns. 1994,23: 115-124.
14.
14. Marrero DG, Vandagriff JL, Kronz K, et al. Using telecommunication technology to manage children with diabetes: the Computer-Linked Outpatient Clinic (CLOC) Study. Diabetes Educ. 1995;21:313-319.
15.
15. Mitchell B. The effects of an early intervention strategy in improving the adjustment to diabetes children. Can J Diabetes Care. 1996;20:21-27.
16.
16. Smith KE, Dickerson P, Saylor CF, Jones C. Issues of managing diabetes in children and adolescents: a multifamily group approach. Child Health Care. 1989;18:49-52.
17.
17. Guthrie DW, Sargent L, Speelman D, Parks L. Effects of parental relaxation training on glycosylated hemoglobin of children with diabetes. Patient Educ Couns. 1990;16: 247-253.
18.
18. Anderson K. An evaluation of an adolescent diabetes education program. Can J Diabetes Care. 1997;21:28-33.
19.
19. Horan PP, Yarborough MC, Besigel G, Carlson DR. Computer-assisted self-control of diabetes by adolescents. Diabetes Educ. 1990;16:205-211.
20.
20. Massouh SR, Steele TM, Alseth ER, Diekmann JM. The effect of social learning intervention on metabolic control of insulin-dependent diabetes in adolescents. Diabetes Educ. 1989;1 5:518-521.
21.
21. Grey M, Boland EA, Davidson M, Tamborlane WV. Coping skills training as adjunct for your on intensive therapy. Appl Nurs Res. 1999:3-12.
22.
22. Boardway RH, Delameter AM, Tomakowsky J, Gutai JP. Stress management training for adolescents with diabetes. J Pediatr Psych. 1993;18:29-45.
23.
23. Mendez FJ, Belendez M. Effects of a behavioral intervention on treatment adherence and stress management in adolescents with IDDM. Diabetes Care. 1997;20:1370-1375.
24.
24. Siminerio LM. Establishment of a diabetes youth group. Diabetes Educ. 1980;6:22-23.
25.
25. Warren-Boulton E, Anderson BJ, Schwartz NL, Drexler AJ. A group approach to the management of diabetes in adolescents and young adults. Diabetes Care. 1981;4: 620-623.
26.
26. Farquhar JW. Use of a teleport system in parent and adolescent support. Diabetic Med. 1989;6:635-637.
27.
27. Daley BJ. Sponsorship for adolescents with diabetes. Health Soc Work. 1992;17: 173-182.
28.
28. Smith KE, Schreiner B-J, Brouhard BH, Travis LB. Impact of a camp experience on choice of coping strategies by adolescents with insulin dependent diabetes mellitus. Diabetes Educ. 1991;17:49-53.
29.
29. Anderson BJ, Wolf FM, Burkhart MT, Cornell RG, Bacon GE. Effects of peer-group intervention on metabolic control of adolescents with IDDM: randomized outpatient study. Diabetes Care. 1989; 12:179-183.
30.
30. Satin W, LaGreca AM, Zigo MA, Skyler JS. Diabetes in adolescence: effects of a multifamily group intervention and parent simulation of diabetes. J Pediatr Psychol. 1989;1 4:259-275.
31.
31. Wysocki T, Greco P, Harris M, et al. Behavior therapy for families of adolescents with IDDM: maintenance of treatment effects. Diabetes. 1997;46:351-351.
32.
32. Wysocki T, Harris MA, Greco P, et al. Social validity of support group and behavior therapy interventions for families of adolescents with insulin dependent diabetes mellitus. J Pediatr Psychol. 1997;22:635-649.
33.
33. Brandt PA, Magyary DL. The impact of a diabetes education program on children and mothers. J Pediatr Nurs. 1993;8:31-40.
34.
34. McNabb WL, Quinn MT, Murphy DM, Thorp FK, Cook S. Increasing children's responsibility for self-care: the In-Control Study. Diabetes Educ. 1994;20:121-124.
35.
35. Gross AM, Johnson WG, Wildman H, Mullett N. Coping skills training with insulin-dependent pre-adolescent diabetics. Child Behav Ther. 1982;3: 141-153.
36.
36. Gross AM, Heiman L, Shapiro R, Schultz RM. Children with diabetessocial skills training and hemoglobin A1c levels. Behav Modif. 1983;7:151-165.
