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Pediatr Diabetes. 2019 Dec 29. doi: 10.1111/pedi.12975. [Epub ahead of print]

School-aged children with type 1 diabetes benefit more from a coping skills training program than adolescents in China: 12-month outcomes of a randomized clinical trial.

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Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
Shenzhen University, Shenzhen, Guangdong, China.
School of Medicine, University of California San Francisco, San Francisco, California, USA.
Second Xiangya Hospital, Changsha, Hunan, China.
School of Nursing, Yale University, New Haven, Connecticut, USA.



Managing type 1 diabetes can be challenging, especially for youth, so there is a need for effective interventions to help youth live with diabetes.


To determine the efficacy of a coping skills training program for Chinese youth with type 1 diabetes and to explore whether the efficacy of the program was different for school-aged children than for adolescents with type 1 diabetes.


A total of 100 youth with type 1 diabetes aged 8 to 20 years were randomly placed in either an intervention group (coping skills training + standard care) or a control group (standard care). Data were collected at baseline, 6-month, and 12-month follow-ups on primary outcomes of perceived stress, coping, and self-efficacy and secondary outcomes of diabetes self-management, quality of life, and glycated hemoglobin (HbA1c). A generalized estimating equation analysis for repeated measures was used to determine the program effects and differential effects by age group.


The coping skills training program had no significant effect on primary or secondary outcomes over 12 months. However, there was a significant increase in positive coping (P < .001), self-efficacy (P = .017), diabetes problem-solving and goals of diabetes self-management (P = .007, P = .001), and quality of life (P = .016) of school-aged children in the intervention group compared with the control group. There were no significant differences in primary or secondary outcomes between the intervention group and the control group (P > .05).


The coping skills training program was effective for school-aged children, improving psychosocial and diabetes self-management outcomes. Further research is needed to develop programs that improve outcomes in adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved.


adolescents; children; coping skills training; type 1 diabetes


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