1842-LB: Adapting Behavioral Family Systems Therapy for Diabetes (BFST-D), a Virtual Family-Based Intervention for Improving Transition Readiness in Youth with Type 1 Diabetes (T1D)

Introduction & Objective: Many youth with T1D do not transfer to adult diabetes care successfully, resulting in adverse medical and psychosocial outcomes. Modifiable individual and family factors are associated with transition, yet there are no empirically-based interventions targeting such factors. The objective of this study is to (1) describe the adaptation of BFST-D to BFST-DT, a virtual family-based T1D transition intervention, and (2) describe baseline findings of a pilot pre-post intervention trial.

Methods: Focus groups were conducted to inform the adaptation of BFST-D to address transition readiness. A pilot trial assessed acceptability/feasibility of the intervention in 30 families. Analyses evaluated transition readiness and psychosocial variables at baseline.

Results: Eight focus groups of youth with T1D, their caregivers, and diabetes providers (total n=44) were conducted. Thematic analysis revealed individual and family-level barriers and facilitators to transition and feedback on the adapted intervention. Twenty adolescents (Mage= 16.6 years; 55% female) and their caregiver (95% mothers) are currently enrolled in the intervention. At baseline, adolescents reported the greatest transition readiness in insulin/pump management (M=4.33), followed by health behaviors (M=3.73), diabetes knowledge (M=2.64), and healthcare navigation (M=2.27). Total transition readiness was correlated with diabetes-related resilience and distress, and parent self-reported diabetes-related distress, self-efficacy, and family conflict (p’s < .05).

Discussion: Stakeholder focus groups highlighted the need for a family-based T1D transition intervention and were vital to BFST-DT development. Transition readiness is associated with individual and family-level psychosocial variables. Future studies will evaluate the efficacy and acceptability/feasibility of BFST-DT.