Introduction and Objective: Behavioral Family Systems Therapy for Diabetes (BFST-D), a family-based pediatric psychosocial type 1 diabetes (T1D) intervention, improves glycemic levels and family conflict. A brief group-based version of bBFST-D has evidence of effectiveness. However, few families receive this care. Using evidence-based quality improvement (EBQI), the current study aimed to develop and tailor a toolkit of implementation strategies for bBFST-D.Methods: Following steps of EBQI, a Family Advisory Board (FAB) and Healthcare Professionals Advisory Board (HPAB) from one free-standing children’s hospital provided iterative feedback to (1) prioritize barriers, (2) select, specify, and tailor implementation strategies, and (3) create a toolkit. The FAB included 4 adolescents with T1D (3 males, Mag e= 14.00 ± 0.82, 75% African American, 100% Non-Hispanic, MHbA1c = 11.00 ± 2.25, 50% Medicaid) and their caregivers (3 mothers, 1 father, Mage = 43.75 ± 2.22, 75% African American, 100% Non-Hispanic). The HPAB included 5 T1D professionals (Mage = 47.20 ± 11.78; 3 females, 100% White, Non-Hispanic). Three FAB and five HPAB virtual meetings were held.Results: The FAB selected and tailored strategies to address key barriers to engaging in bBFST-D, such as timing (evening), format (telehealth), and medical provider education (communication with families). The HPAB identified key malleable barriers to bBFST-D implementation (medical provider efficacy in how to refer, psychosocial provider knowledge of bBFST-D), provided feedback on the acceptability, feasibility, and effectiveness of implementation strategies (education, champions, facilitation, audit and feedback), and then on an implementation toolkit.Conclusion: The process of using EBQI to engage diverse community partners for tailoring implementation strategies optimized the likelihood that the toolkit will effectively increase the reach of bBFST-D and improve the health of youth with T1D and their families.
J. Price: None. C. Yang: None. J.A. Deatrick: None. C. Thomas: None. G. Curran: None. A. Kazak: None.
National Institute of Diabetes and Digestive and Kidney Diseases (5K23DK125666)
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