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Diabetes Educ. 2019 Aug;45(4):420-430. doi: 10.1177/0145721719858080. Epub 2019 Jun 27.

Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes.

Author information

Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California.
Chan Division of Occupational Science and Occupational Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California.
Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, Colorado.
Department of Telehealth, School of Medicine, University of Colorado, Aurora, Colorado.
Department of Psychiatry, School of Medicine, University of Colorado, Aurora, Colorado.
Department of Epidemiology, School of Public Health, University of Colorado, Aurora, Colorado.



To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D).


YAs self-selected to participate in the CoYoT1 Clinic or serve as a usual care control. CoYoT1 Clinic visits consisted of an individual appointment with a provider and a group appointment with other YAs with T1D using home telemedicine. Psychosocial and behavioral functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy for Diabetes Scale, Self-Management of Type 1 Diabetes in Adolescence Scale, and Center for Epidemiologic Studies Depression Scale.


Forty-two patients participated in the CoYoT1 Clinic and 39 patients served as controls. CoYoT1 participants reported lower levels of distress (P = .03), increased diabetes self-efficacy (P = .01), and improved ability to communicate with others about diabetes (P = .04) over the study period compared to controls. YA males in the control group reported increases in depressive symptoms (P = .03) during the study period, but CoYoT1 participants showed no changes.


Group home telemedicine for YAs with T1D positively affects diabetes distress, self-efficacy, and diabetes-specific communication. These positive findings have the potential to also affect the YAs' long-term diabetes outcomes. Further investigation of the model is needed.


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