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JMIR Res Protoc. 2016 Jul 28;5(3):e151. doi: 10.2196/resprot.5817.

Use of Relational Agents to Improve Family Communication in Type 1 Diabetes: Methods.

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USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.



Physiological and environmental risk factors interact to undermine blood glucose control during early adolescence. This has been documented to be associated with family conflict and poor adherence to diabetes management tasks. Family Teamwork is an efficacious program demonstrated to enhance family communication and reduce conflict during this vulnerable period. It was designed to be delivered to families in-person, which limited reach and potential impact.


The purpose of this paper is to present the protocol for adapting Family Teamwork for Web-based delivery.


Formative research with health care providers, parents, and adolescents will help modify Family Teamwork for Web-based delivery by a relational agent (ie, a computerized character with human-like features and actions). Sessions will be interactive, requiring both parent and adolescent participation, with the relational agent serving as a health coach. After programming, usability testing will be conducted to help ensure the program is easy to use. Video and instructional materials will be developed to facilitate use, and a small pilot study will be conducted to assess feasibility. Families will provide written informed consent prior to participation in any phase of the study. The Institutional Review Board at Baylor College of Medicine reviewed and approved the protocol (H-37245).


Formative research is underway. No results are available at this time.


This research has the potential to make an important contribution to diabetes management by using technology to enhance the reach of an efficacious program.


adolescents; family communication; pre-adolescents; relational agent; type 1 diabetes

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