Pilot, feasibility, and acceptability evaluation of a mindfulness-based intervention with diabetes education in adolescents with type 1 diabetes

INTRODUCTION: Most adolescents living with type 1 diabetes (T1D) do not reach targeted levels of hemoglobin A1c (HbA1c), which increases risk for diabetes-related complications. Suboptimal diabetes management may be associated with the burden of coping with T1D for adolescents who are simultaneously adjusting to physical, cognitive, and socioemotional changes. Mindfulness-based interventions (MBIs) are associated with improved coping skills and could be useful for adolescents with T1D. METHODS: This was a pilot randomized controlled study to examine the feasibility and acceptability of a virtual MBI in adolescents aged 15-17 years with T1D. Enrollment took place in two iterations: 1) patients were approached in clinic by a physician; 2) letters were mailed and follow-up phone calls were made by research staff. Enrolled participants were given the option of 2 different weekly times for participation and were assigned to one of two study arms: diabetes education + MBI (DE + MBI) or DE only. For each arm, 12 virtual group sessions were held weekly. Feasibility measures included time-to-recruit, program enrollment, and study retention. Acceptability was assessed by attendance and survey completion. Exploratory outcomes included HbA1c and responses to quality of life and mental health questionnaires. RESULTS: By design, the first 60 eligible participants who agreed to participate were enrolled. Sixty of 164 approached (37%) consented to enroll. Fifty percent of these (n = 30; DE + MBI = 15, DE = 15) participated in at least one group session; the mean attendance was 7 + 3 sessions. All participants reported managing at least one area of life better post-intervention (coping with stress, sleep, physical symptoms, self-care, school, emotion regulation, getting along with others). Survey completion was 87% pre-intervention and 60% post-intervention. There was no change in mean HbA1c for either the DE + MBI or the DE arms. CONCLUSION: More study is warranted to investigate ways to increase the feasibility for implementing complementary therapies such as MBI in a diabetes clinic for adolescents with T1D.