Introduction and Objective: Adolescents with Type 1 diabetes (T1D) report high levels of anxiety symptoms which are associated with poor quality of life (QoL) and out-of-range hemoglobin A1c. Mindfulness-based stress reduction (MBSR) is a manualized, evidence-based treatment for anxiety symptoms. We designed an 8-week, remote, asynchronous mHealth application, Appricate©, delivering mindfulness-training modeled on the MBSR program to adolescents with T1D. We examined feasibility, acceptability and preliminary efficacy of Appricate©. Methods: We conducted a pilot study of Appricate© in 28 adolescents with T1D. Eligible participants were: (1) aged 12 to 19 years; (2) diagnosed with T1D for 6 months; (3) read/speak English fluently; (4) had access to a mobile phone. We measured anxiety symptoms, diabetes-specific QoL diabetes self-care, sleep quality, and hemoglobin A1c at baseline and post-intervention (12 weeks). Demographic characteristics were collected at baseline. Changes were evaluated using paired t-tests. Results: Most participants were female (60.7%), white (75%), non-Hispanic (92.9%), used an insulin pump (96.4%), and had diabetes for three to five years (64.3%). We established feasibility ( 85% response rate, 70% completion rate, 20% attrition rate) and acceptability (85% weekly engagement) of Appricate©. While not powered to assess efficacy, Appricate© led to a significant decrease in anxiety symptoms (p0.05) and a significant increase in QoL (p0.01) and sleep quality (p0.1). Conclusion: Appricate© is feasible and acceptable to adolescents with T1D and has promise in improving psychosocial symptoms. Given the established associations between psychosocial and glycemic outcomes, Appricate© has the potential to improve both in adolescents with T1D. A fully-powered randomized controlled trial is needed to determine efficacy. Disclosure K. Rechenberg: None. R. Koerner: None. Funding National Institutes of Health (K23NR019911)
Rechenberg et al. (Fri,) studied this question.