Introduction and Objective: Up to 30% of youth with type 1 diabetes (T1D) report elevated depressive symptoms, which negatively impact T1D management. Behavioral health interventions exist to improve mood and promote treatment engagement, but their high cost and long duration are implementation barriers. Further, <25% of youth with T1D referred for mental health services attend >1 session. To address these barriers, we aimed to adapt an evidence-based depression single-session intervention (SSI) to meet the unique needs of adolescents with T1D.Methods: We conducted semi-structured interviews with 5 diabetes providers (i.e., physicians, nurse practitioners, social workers) and 15 youth aged 13-17 years with T1D. Interviews were audio-recorded and transcribed verbatim. We conducted thematic analysis to explore patterns and identify underlying themes related to depression-specific barriers to diabetes care, which informed our SSI modifications. All participants completed a demographic form, and adolescents completed the PHQ-9.Results: Adolescents had an average PHQ-9 score of 9 (SD=4.8), indicating mild-to-moderate depressive symptoms. They described how low mood and depressive symptoms contribute to avoidance of T1D tasks (i.e., administering insulin, changing pump sites) and how interpersonal stressors (e.g., family conflict and stigma) exacerbated this avoidance. Providers noted that youth with elevated depressive symptoms appear withdrawn during appointments, and insulin administration is the most impacted area of T1D care.Conclusion: Our interviews suggest depressive symptoms and family stress contribute to avoidance of T1D tasks, with insulin administration most impacted. Next steps will integrate adolescent and provider perspectives into a new T1D-specific depression SSI and pilot test within a randomized control trial. If found feasible and acceptable, the T1D-specific depression SSI may serve as a lower barrier, scalable entry point to mental health care.
A. Monzon: None. S. Ulysse: None. S. Nozime: None. J. Pierce: None. N. Vyas: Other – Sponsored travel; Ended; Insulet Corporation. Advisory Panel; Ended; Sanofi. S.R. Patton: Advisory Panel; Current; Glooko, Inc.
National Institutes of Health (K23DK139431)
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