Evaluation of a multicomponent, behaviorally oriented, problem-based "summer school" program for adolescents with diabetes.

A 2-week summer school program, combining problem-based learning with behavior therapy, was developed to help adolescents with insulin-dependent diabetes improve their ability to cope with obstacles to dietary management. Ten students participated in a first session, and 9 participated in a second session, serving as a waiting list control group. Outcomes were evaluated pre- and postsession and at a 4-month follow-up using 3-day food diaries, blood glucose data, and paper-and-pencil tests of diabetes-related knowledge, self-efficacy, coping strategies, and general problem solving. Improvements were observed in self-efficacy, problem-solving skills, and self-reported coping strategies. No significant changes were observed in daily intake of fat, cholesterol, calories, mean blood glucose levels or blood glucose variability, and diabetes knowledge. Comparisons between the first group and the waiting list control group do not allow the significant pre-post changes to be clearly attributed to the summer school program.

Assessing and overcoming situational obstacles to dietary adherence in adolescents with IDDM.

PURPOSE: To develop and evaluate a tool for assessing selected aspects of dietary adherence in adolescents with diabetes mellitus (IDDM). METHODS: The Situational Obstacles to Dietary Adherence Questionnaire (SODA) is a 30-item inventory that yields a total self-efficacy score and scales that measure cognitive and behavioral coping strategies. Alternative forms of the SODA were administered at the beginning and end of a summer camp for youngsters with IDDM in order to obtain evidence for its reliability and validity, and to evaluate the impact of an educational intervention. The program consisted of two 50-minute small group sessions intended to help adolescents with IDDM improve their ability to cope with challenging dietary situations. Using the method of anchored instruction, the campers first viewed a video about a teenager with diabetes who faces common situations that make diabetes self-management difficult. Group problem-solving sessions led by a registered dietitian were used to help campers learn more effective ways to solve dietary problems. RESULTS AND CONCLUSIONS: Results suggested that the SODA has reasonable reliability and validity. In addition, anchored instruction improved dietary self-efficacy and changed young adolescents' estimates of how often they would use selected cognitive and behavioral strategies to solve dietary problems.