First name
Nathalie
Last name
Slick

Title

Youth Involvement in the Decision to Start CGM Predicts Subsequent CGM Use.

Year of Publication

2020

Number of Pages

Date Published

2020 Jul 23

ISSN Number

1935-5548

Abstract

<p><strong>OBJECTIVE: </strong>The ability of continuous glucose monitoring (CGM) to improve diabetes outcomes depends upon consistent use. To identify factors that facilitate long-term use of CGM, this study tested the hypothesis that youth involvement in the decision to initiate this therapy would influence subsequent CGM use and that CGM self-efficacy and satisfaction mediate this relationship.</p>

<p><strong>RESEARCH DESIGN AND METHODS: </strong>Before initiating CGM, parent-youth dyads (i.e., pairs) from an academic endocrinology clinic completed assessments, including a measure of the child's involvement in the decision to start CGM. Two months into CGM use, youth completed measures of CGM self-efficacy and satisfaction. Fidelity of CGM use between weeks 5 and 12 was accessed via a cloud-based data repository. Hypotheses were tested with linear mixed effects models, accounting for patients clustered within provider and repeated measures within patients.</p>

<p><strong>RESULTS: </strong>CGM use in 108 dyads (youth mean age 13.4 ± 2.7 years; 73% white) was positively predicted by baseline parent report of youth involvement in the CGM decision ( &lt; 0.0001), and this relationship was mediated by youth's perceptions of CGM self-efficacy ( &lt; 0.0001) and hassle ( = 0.014). So, when the youth shared their opinions about CGM with parents and participated in the decision to start, they perceived higher self-efficacy and lower hassle at 2-month follow-up, which predicted more days of use. This pattern held in models adjusting for youth race and sex and family income.</p>

<p><strong>CONCLUSIONS: </strong>To achieve maximum clinical benefit from CGM use, providers should facilitate youth involvement in the decision to initiate the device.</p>

DOI

10.2337/dc20-0348

Alternate Title

Diabetes Care

PMID

32703764
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