For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school-aged youth. Youth with T1D, 11–13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed-effects models. Eighty-six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the 12-month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p = 0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p = 0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. Participation in Team Clinic was associated with improved psychosocial outcomes in middle school-aged participants with T1D.

中文翻译：

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参与共享医疗预约的 1 型糖尿病青少年的心理社会结果

对于患有 1 型糖尿病 (T1D) 的青年，青春期早期与糖尿病管理恶化和消极心理社会问题的高发率有关，包括抑郁症状和家庭冲突。替代临床模型可能有助于改善糖尿病和心理社会结果。我们的研究旨在调查团队诊所（一种专门为患有 T1D 的青少年开发的共享医疗预约模型）是否会改善中学生的心理社会结果。11-13 岁的 T1D 青少年及其护理人员参加了一项随机对照试验，将 Team Clinic 与传统诊所就诊进行比较（对照组）。在每次就诊时获得糖尿病特征。参与者和照顾者在基线和研究结束时完成了抑郁症筛查和家庭冲突问卷。使用线性混合效应模型比较了从基线到研究结束时临床和心理社会结果平均得分的变化。86 名青年（51% 女性；74% 白人；10% 西班牙裔）在 12 个月的研究期间完成了至少一次访问。在研究结束时，与团队诊所参与者相比，对照组参与者报告的情绪问题有所增加，包括更高水平的负面情绪/身体症状（p  = 0.02)。与对照组参与者相比，Team Clinic 参与者报告在研究结束时围绕糖尿病的家庭冲突减少（p  = 0.03）。护理人员在研究期间没有报告抑郁症状或家庭冲突的变化。两组的血红蛋白 A1C 水平均未随时间变化。参加团队诊所与 T1D 中年参与者的心理社会结果改善有关。