Increasing Anticipatory Guidance Discussions Among Parents of Adolescents With Type 1 Diabetes to Promote Transitional Care

Background: Transitioning adolescents with type one diabetes (T1D) are at increased risk for reduced continuity of care, long term complications, poor glycemic control, and hospitalizations. Education programs have been found to improve knowledge; strengthen relationships among the parent, provider, and adolescent; and improve self-efficacy during transition. Purpose: To refine evidence-based anticipatory guidance (AG) tools developed for parents of adolescents with T1D, increase AG discussions, and promote healthy relationships between parents and adolescents with T1D to improve an adolescent's readiness for transitional care. Methods: Parents of adolescents with T1D, ages 11 to 21 years, were recruited from diabetes online communities. Using a mixed-methods approach guided by the Framework for Emerging Adults with T1D, assessment of current AG use by diabetes providers, identification of facilitators and barriers to AG use, and refinement of evidence-based AG tools, AG tools were implemented and evaluated over a 3-week period. Content analysis and descriptive statistics were used to summarize findings and changes to the parent adolescent relationship and the ability to communicate. Results: Significant facilitators and barriers of AG were identified and applied to refine the AG tool. The parents successfully utilized the refined AG tools. Of the parents surveyed (N=14), 30.8% (n=4) reported improvements in their ability to communicate health related information, and 23.1% (n=3) reported improvements in their parent adolescent relationship. Conclusion: The refined AG tools among parents of adolescents with T1D were well received, facilitated conversations about future age-related expectations, and promoted healthy relationships between the parent and adolescent. Implementing the refined AG tool within clinical settings should be considered for future efforts to increase AG conversations among diabetes providers, parents, and adolescents.