Evidence map›Paper›PMID 27284455›Full record

ArticleBMJ open diabetes research & care2016

Effectiveness of a structured educational intervention using psychological delivery methods in children and adolescents with poorly controlled type 1 diabetes: a cluster-randomized controlled trial of the CASCADE intervention.

Deborah Christie, Rebecca Thompson, Mary Sawtell, Elizabeth Allen, John Cairns, Felicity Smith, Elizabeth Jamieson, Katrina Hargreaves, Anne Ingold, Lucy Brooks and 11 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open diabetes research & care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.

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  9. Self-care support of diet and the gut in the routine care of school-age children with long-term conditions: An integrative review.Journal of child health care : for professionals working with children in the hospital and community · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 5 institutions in 1 country.

Deborah ChristieUniversity College London Hospitals NHS Foundation Trust , London , UK.
Rebecca ThompsonUniversity College London Hospitals NHS Foundation Trust , London , UK.
Mary SawtellSocial Sciences Research Unit , Institute of Education , London , UK.
Elizabeth AllenLondon School of Hygiene and Tropical Medicine , London , UK.
John CairnsLondon School of Hygiene and Tropical Medicine , London , UK.
Felicity SmithUCL School of Pharmacy , London , UK.
Elizabeth JamiesonUCL School of Pharmacy , London , UK.
Katrina HargreavesSocial Sciences Research Unit , Institute of Education , London , UK.
Anne IngoldSocial Sciences Research Unit , Institute of Education , London , UK.
Lucy BrooksLondon School of Hygiene and Tropical Medicine , London , UK.
Meg WigginsSocial Sciences Research Unit , Institute of Education , London , UK.
Sandy OliverSocial Sciences Research Unit , Institute of Education , London , UK.
Rebecca JonesLondon School of Hygiene and Tropical Medicine , London , UK.
Diana ElbourneLondon School of Hygiene and Tropical Medicine , London , UK.
Andreia SantosLondon School of Hygiene and Tropical Medicine , London , UK.
Ian C K WongUCL School of Pharmacy , London , UK.
Simon O'NeilDiabetes UK , London , UK.
Vicki StrangeSocial Sciences Research Unit , Institute of Education , London , UK.
Peter HindmarshUniversity College London Hospitals NHS Foundation Trust , London , UK.
Francesca AnnanRoyal Liverpool Children's Hospital NHS Trust , Liverpool , UK.
Russell M VinerUCL Institute of Child Health , London , UK.
London School of Hygiene & Tropical Medicine · GBUniversity College London · GBUniversity College London Hospitals NHS Foundation Trust · GBDiabetes UK · GBThe London College · GB

Funding

Department of Health 06/44/05
6 · The paper itself

Abstract

introductionType 1 diabetes (T1D) in children and adolescents is increasing worldwide with a particular increase in children <5 years. Fewer than 1 in 6 children and adolescents achieve recommended glycated hemoglobin (HbA1c) values.

methodsA pragmatic, cluster-randomized controlled trial assessed the efficacy of a clinic-based structured educational group incorporating psychological approaches to improve long-term glycemic control, quality of life and psychosocial functioning in children and adolescents with T1D. 28 pediatric diabetes services were randomized to deliver the intervention or standard care. 362 children (8-16 years) with HbA1c≥8.5% were recruited. Outcomes were HbA1c at 12 and 24 months, hypoglycemia, admissions, self-management skills, intervention compliance, emotional and behavioral adjustment, and quality of life. A process evaluation collected data from key stakeholder groups in order to evaluate the feasibility of delivering the intervention.

results298/362 patients (82.3%) provided HbA1c at 12 months and 284/362 (78.5%) at 24 months. The intervention did not improve HbA1c at 12 months (intervention effect 0.11, 95% CI -0.28 to 0.50, p=0.584), or 24 months (intervention effect 0.03, 95% CI -0.36 to 0.41, p=0.891). There were no significant changes in remaining outcomes. 96/180 (53%) families in the intervention arm attended at least 1 module. The number of modules attended did not affect outcome. Reasons for low uptake included difficulties organizing groups and work and school commitments. Those with highest HbA1cs were less likely to attend. Mean cost of the intervention was £683 per child.

conclusionsSignificant challenges in the delivery of a structured education intervention using psychological techniques to enhance engagement and behavior change delivered by diabetes nurses and dietitians in routine clinical practice were found. The intervention did not improve HbA1c in children and adolescents with poor control. TRIAL REGISTRATION NUMBER: ISRCTN52537669, results.

Indexed as

Adolescent DiabetesEducation and Behavioral InterventionsPsychologyRandomized Controlled Trial

Identifiers

PMID27284455
PMCPMC4893872
OpenAlexW2408996308

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.