Camp based multi-component intervention for families of young children with type 1 diabetes

Purpose Type 1 diabetes mellitus now occurs in ~1/500 children [Less Than]19[?]year old. Because microvascular complications of diabetes are directly correlated with disease duration and inversely related to glycemic control, improving glycemic control in young children with diabetes may have disproportionately large benefits on future complication risk. The developing brains of children may be far more sensitive to adverse effects of both hyperglycemia and hypoglycemia, both of which may have subtle effects on cognition and neuroanatomy. Thus, interventions in young children should target both hyperglycemia and hypoglycemia. But diabetes management is particularly challenging in young children, owing to their immature communication skills, limited tolerance for hypoglycemia, impulsive behavior, and irregular diet and activity patterns. Stresses on parents of young diabetic children may lead to reinforcement of dysfunctional behaviors. effective interventions must address these barriers to good glycemic control. The intervention will be based at north Texas Jellystone Park (2301 S Burleson Blvd, Burleson TX, 76029) a regional location that is routinely used for retreats and summer camps. The proposed camp encounters aim to provide: * an opportunity for intensive education beyond that achievable in a single class, and without the unfavorable impacts of multiple weekday classes on family and work time. * Varied educational modalities including didactic sessions, practical demonstrations and role playing. * Close observation of each child throughout the day by experienced medical staff to identify and help correct maladaptive family behaviors. * a safe environment where parents can participate in group therapy sessions without child care worries. * an opportunity for age-appropriate child-centered educational and therapeutic activities. * an opportunity for families to form mutually-supportive friendships. * Fun weekend away where the parents have help caring for their child with diabetes. Primary objective We will conduct a pilot study, which will enroll 30 preschool children age 3-5.5 years, with the goal of obtaining preliminary results for 24 subjects. The primary outcome, to be determined approximately one month before and 3 months after the camp session, is improvement in Hemoglobin a1c (Hba1c). Secondary objectives Behavioral/quality of life assessments (completed by the parents) These will include the parent of young children version of the Hypoglycemia Fear Survey (HFS-P-YC), the modified Behavioral Pediatric Feeding assessment Scale (BPFa), The Perceived Diabetes Self-Management Scale for Parents of Children with Diabetes (PDSMS), the Pediatric inventory for Parents (PiP) and the Generic Core and Diabetes modules of the Pediatric Quality of Life inventory (PedsQL). Primary hypothesis Subjects attending a weekend session at a family diabetes camp will improve Hba1c three months after the camp session, compared with pretreatment baseline, with greater improvement in subjects with suboptimal glycemic control (Hba1c [Greater Than] 8.0%). exploratory hypotheses Compared with pretreatment baseline, subjects attending a weekend session at a family diabetes camp will improve: * Behavioral/Quality of Life assessments, including the parents of young children version of the hypoglycemia fear survey (HFS-P-YC), the modified Behavioral Pediatrics Feeding assessment Scale(BPFa), the Perceived Diabetes Self-Management Scale for Parents of Children with Diabetes (PDSMS), the Pediatric inventory for Parents (PiP) and the general and diabetes modules of the PedsQL.