This honors thesis presents a secondary analysis of a multi-site pilot intervention aimed at improving glycemic management among adolescents with type 1 diabetes through behaviorally informed strategies. Participants were classified as responders or non-responders based on a ≥0.3% reduction in HbA1c. The study explored relationships between glycemic outcomes and key intervention components, including Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) action planning, Behavior Change Technique (BCT) use, and self-monitoring in response to text message prompts. Overall, modest improvements in HbA1c were observed, with notable variability by sex. A greater proportion of females were classified as responders compared to males, and sex-based differences emerged in engagement patterns. Responders demonstrated greater overall engagement with intervention components, including more frequent SMART goal setting, higher diversity of BCT types, and greater responsiveness to text message prompts. Similarly, females exhibited consistently higher engagement across these domains, including setting SMART goals more frequently, engaging with a broader range of BCTs, and logging more frequently in response to text messages, which may have created conditions that facilitated greater clinical improvement. These findings highlight the importance of examining behavioral engagement patterns and suggest that tailoring of intervention components to enhance participant engagement may improve clinical outcomes in adolescents with type 1 diabetes.
Erin Walter (Wed,) studied this question.
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