664-P: Preliminary Results of a New Scalable Digital Treatment for Diabetes Distress (DD) in Families of School-Age Children with Type 1 Diabetes (T1D)

We present feasibility, acceptability, and efficacy of 3 delivery arms of a new scalable, digital treatment we designed to target DD in families of school-agers with T1D. We randomized 34 families (mean child age= 10 + 1.4 years; 53% male, 85% White, mean HbA1c= 7.24 + 0.71%) to 1 of 3 delivery arms differing only by number of telehealth visits: 0 visits= self-guided (SG), 3 visits= enhanced self-guided (ESG), or 8 visits= video visits (VV). All families had 24x7 access to digital treatment materials via their hospital’s patient portal app for 10 weeks. We recorded telehealth visit attendance (ESG & VV families) to examine feasibility. We compared parent and child treatment satisfaction by delivery arm to examine acceptability. We compared parent and child DD using the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, respectively) by time and delivery arm to test efficacy. 81% of ESG families attended all 3 and 20% of VV families attended all 8 telehealth visits. Parents and children reported high satisfaction scores with no differences by delivery arm. There were significant pre-post reductions in PPAIDC (p=0.026) and PAIDC (p=0.026) scores but no differences by delivery arm. All 3 delivery arms appear acceptable and may reduce DD in families of school-agers with T1D. However, without the burden of telehealth visits, SG may be more feasible than the other delivery arms.