{
  "abstract": "Background: Parents of young children with type 1 diabetes (T1D) frequently report fear of hypoglycemia (FH), which can impact their diabetes management. REDCHiP (Reducing Emotional Distress for Childhood Hypoglycemia in Parents) is a telehealth-delivered cognitive behavioral intervention shown to reduce FH, but less is known about which parents benefit most.\n\nObjective: This secondary analysis examined whether pretreatment parent anxiety moderated REDCHiP’s effects and explored responder patterns by intervention arm and pretreatment anxiety.\n\nMethods: This was a secondary analysis of a large, randomized clinical trial comparing REDCHiP to an attention control condition (ATTN). We assessed outcomes before treatment (time 1) and 3 months after treatment (time 3). Our primary outcome was parental FH at time 3, adjusted for time 1 FH. The original trial used validated measures of parent FH and general anxiety. We evaluated parent anxiety at time 1 as both a categorical variable (clinically elevated or not) and a continuous variable (centered). We defined responders as parents achieving a reduction of ≥0.5 SDs in FH from time 1 to time 3. An analysis of covariance tested the treatment arm by anxiety interaction, with sensitivity analyses modeling anxiety continuously.\n\nResults: There was no significant treatment arm by anxiety interaction when modeling parent anxiety as either a categorical or continuous variable (P>.05). However, exploratory analyses found that the adjusted mean time 3 FH was numerically lower among REDCHiP parents than ATTN parents with clinically elevated anxiety. Among parents with elevated anxiety, 78.6% (22/28) of REDCHiP parents met our responder criterion compared with 47.4% (9/19) of ATTN parents. Among parents with elevated anxiety, the adjusted odds of meeting the responder criterion were higher for REDCHiP than ATTN parents (odds ratio 6.35, 95% CI 1.47‐29.00).\n\nConclusions: While time 1 parent anxiety did not significantly moderate treatment response, exploratory analyses suggested a potentially meaningful pattern among parents with clinically elevated anxiety. As telehealth-delivered behavioral interventions expand in pediatric type 1 diabetes care, secondary analyses of participant characteristics may help guide targeted implementation and enhance treatment benefit.",
  "abstract_shown": true,
  "affiliations": [
    "Center for Healthcare Delivery Science, Nemours Children's Clinic, 807 Children's Way, Jacksonville, FL, 32207, United States, 1 904-697-3595, 1 904-697-3425",
    "Center for Healthcare Delivery Science, Nemours Children's Clinic, Orlando, FL, United States",
    "Division of Psychology, Nemours Children's Clinic, Jacksonville, FL, United States",
    "Division of Endocrinology, Children's Mercy Hospital, Kansas City, MO, United States",
    "Center for Diabetes Technology, University of Virginia, Charlottesville, VA, United States"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Susana R Patton",
      "orcid": "0000-0002-8902-6965"
    },
    {
      "affs": [
        1
      ],
      "name": "Alexandra Monzon",
      "orcid": "0000-0003-1492-5074"
    },
    {
      "affs": [
        2
      ],
      "name": "Nicole Kahhan",
      "orcid": "0000-0002-7973-2153"
    },
    {
      "affs": [
        3
      ],
      "name": "Jacob Redel",
      "orcid": "0000-0003-3978-8491"
    },
    {
      "affs": [
        4
      ],
      "name": "Kimberly Driscoll",
      "orcid": "0000-0002-3006-4633"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0gywxfayktmr5.bib",
  "cited_by": 0,
  "doi": "10.2196/95475",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730211/",
  "id": "0gywxfayktmr5",
  "issns": [
    "2561-6722"
  ],
  "landing_url": "https://doi.org/10.2196/95475",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Diabetes"
    ],
    [
      "heading",
      "Original Paper"
    ],
    [
      "heading",
      "Parenting"
    ],
    [
      "heading",
      "Pediatrics"
    ],
    [
      "heading",
      "Telemedicine for Diabetes"
    ],
    [
      "heading",
      "Telepediatrics"
    ],
    [
      "openalex",
      "2712|Diabetes Management and Research"
    ]
  ],
  "openalex": "W7216090002",
  "pdf_url": null,
  "pmcid": "PMC13730211",
  "pmid": "42976196",
  "published": "2026-11-03",
  "publisher": "JMIR Publications Inc.",
  "ris": "https://research.draconitic.com/paper/0gywxfayktmr5.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:48Z",
      "native_id": "PMC13730211",
      "source": "pmc",
      "url": "https://doi.org/10.2196/95475"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Diabetes",
      "subfield": "endocrinology-metabolism"
    },
    {
      "field": "medicine",
      "origin": "heading:Pediatrics",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Parent Anxiety and Response to a Telehealth Intervention for Hypoglycemia Fear: Secondary Analysis of a Randomized Trial",
  "title_text": "Parent Anxiety and Response to a Telehealth Intervention for Hypoglycemia Fear: Secondary Analysis of a Randomized Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:48Z",
  "url": "https://research.draconitic.com/paper/0gywxfayktmr5",
  "venue": "JMIR Pediatrics and Parenting",
  "versions": []
}