Work

Parent Anxiety and Response to a Telehealth Intervention for Hypoglycemia Fear: Secondary Analysis of a Randomized Trial

Year: 2026

Type: article

Abstract: Background: Parents of young children with type 1 diabetes (T1D) frequently report fear of hypoglycemia (FH), which can impact their diabetes management. REDCHiP (Reducing Emotional Distress for Childhood Hypoglycemia in Parents) is a telehealth-delivered cognitive behavioral intervention shown to reduce FH, but less is known about which parents benefit most. Objective: This secondary analysis examined whether pretreatment parent anxiety moderated REDCHiP's effects and explored responder patterns by intervention arm and pretreatment anxiety. Methods: This was a secondary analysis of a large, randomized clinical trial comparing REDCHiP to an attention control condition (ATTN). We assessed outcomes before treatment (time 1) and 3 months after treatment (time 3). Our primary outcome was parental FH at time 3, adjusted for time 1 FH. The original trial used validated measures of parent FH and general anxiety. We evaluated parent anxiety at time 1 as both a categorical variable (clinically elevated or not) and a continuous variable (centered). We defined responders as parents achieving a reduction of ≥0.5 SDs in FH from time 1 to time 3. An analysis of covariance tested the treatment arm by anxiety interaction, with sensitivity analyses modeling anxiety continuously. Results: >.05). However, exploratory analyses found that the adjusted mean time 3 FH was numerically lower among REDCHiP parents than ATTN parents with clinically elevated anxiety. Among parents with elevated anxiety, 78.6% (22/28) of REDCHiP parents met our responder criterion compared with 47.4% (9/19) of ATTN parents. Among parents with elevated anxiety, the adjusted odds of meeting the responder criterion were higher for REDCHiP than ATTN parents (odds ratio 6.35, 95% CI 1.47-29.00). Conclusions: While time 1 parent anxiety did not significantly moderate treatment response, exploratory analyses suggested a potentially meaningful pattern among parents with clinically elevated anxiety. As telehealth-delivered behavioral interventions expand in pediatric type 1 diabetes care, secondary analyses of participant characteristics may help guide targeted implementation and enhance treatment benefit.

Source: JMIR Pediatrics and Parenting

DOI: 10.2196/95475

Authors: Susana R Patton, Alexandra Monzon, Nicole Kahhan, Jacob Redel, Kimberly Driscoll

Institutions: Nemours Children's Clinic, Nemours Children's Clinic, Nemours Children’s Clinic, Children's Mercy Hospital, University of Virginia

Language: English

Topic: Diabetes Management and Education

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,605