There is an urgent need to address medical and psychosocial needs of adolescents with T1D. Baseline sample characteristics and study progress data are presented from a combined in-person/telehealth RCT using multiphasic optimization strategy (2x2 factorial design) to improve A1C in 10-17 yr olds (≥1 A1C 9-12% in prior yr). During Phase 1, 88 adolescents (target N=100) with T1D (Mage=14.5 yrs; 50% female; 79.5% White, 10.2% Hispanic; 76.1% insulin pump) were randomized to Enhanced Standard Care (Medical visit only every 6 weeks) or Integrated Medical/Psychology (Enhanced Standard Care+Personalized Adherence Feedback Report). During Phase 2 (6-mo visit; N completed=75) all adolescents are re-randomized to another 6 months of intervention every 6 weeks: Enhanced Standard Care or Integrated Medical/Psychology (Enhanced Standard Care+Problem-Solving). During Phase 3 (12-mo visit; N complete=50), psychology support is withdrawn; participants are randomized to Enhanced Standard Care (Medical visit only every 6 weeks) or Standard Care (Medical visit only every 3 months) for 6 months). Adolescents and caregivers download devices and complete psychosocial questionnaires at visits (Table; no statistically significant group differences). N=25 completed the study (18-month visit) and 5 withdrew (94% retention to date); data collection is ongoing.


H. ODonnell: None. G.T. Alonso: None. T. Gomer: None. S. Majidi: Advisory Panel; Self; Companion Medical. J.K. Snell-Bergeon: Stock/Shareholder; Self; GlaxoSmithKline plc. T. Reznick-Lipina: None. R. Wadwa: Advisory Panel; Self; Eli Lilly and Company, Medtronic. Research Support; Self; Dexcom, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk Inc., Tandem Diabetes Care. K.A. Driscoll: None.


National Institute of Diabetes and Digestive and Kidney Diseases (DP3DK113363)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at