{
  "abstract": "OBJECTIVE: To examine feasibility, acceptability, satisfaction, and preliminary efficacy of Diabetes Journey (DJ), a randomized controlled clinical trial for 12- to 17-year-old adolescents with type 1 diabetes (T1D). STUDY DESIGN: = 14.8 ± 1.6 years; 56.4% female) who exceeded the clinical cut-point on the Barriers to Diabetes Adherence (BDA) questionnaire were randomized to DJ (amusement park-themed web modules) or enhanced standard of care (ESC; T1D education toolkit). Data were collected across 9 months, including baseline, posttreatment, follow-up 1 (3 months posttreatment), and follow-up 2 (6 months posttreatment). Primary outcomes were acceptability, feasibility, satisfaction, and BDA Stress/Burnout and Time Pressure/Planning scores at follow-up 1. Secondary outcomes were glycosylated hemoglobin A1c and quality of life. RESULTS: The group × time interaction was significant for the BDA Stress/Burnout subscale. Compared with ESC, the DJ group demonstrated a modest but statistically significant reduction in Stress/Burnout (b = -0.36, P < .05, 95% CI -0.72 to -0.01) and improvements in T1D quality of life (b = 7.09, P = .03, 95% CI 0.59-13.59). No significant differences occurred between groups for time pressure/planning. Adolescents and caregivers in DJ reported greater satisfaction than those in ESC. CONCLUSIONS: Our preliminary findings suggest that DJ had high acceptability, feasibility, and satisfaction. Adolescents randomized to DJ showed signals of reduced stress and burnout and improved quality of life at later follow-up, although these findings should be interpreted cautiously given attrition and the optional nature of the final follow-up assessment. TRIAL REGISTRATION: www. CLINICALTRIALS: gov NCT04404556.",
  "abstract_shown": true,
  "affiliations": [
    "Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229",
    "University of Colorado Anschutz Medical Campus, School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, Aurora, CO 80045",
    "University of Georgia, College of Education, Athens, GA",
    "University of Windsor, Department of Psychology, Windsor, ON N9B3P4, Canada",
    "University of Florida, Department of Clinical and Health Psychology, Gainesville, FL 32610",
    "University of Florida, Department of Pediatrics, Division of Pediatric Endocrinology, College of Medicine, FL 32610",
    "Cincinnati Children’s Hospital Medical Center, Division of Endocrinology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Avani C. Modi"
    },
    {
      "affs": [
        0
      ],
      "name": "Constance A. Mara"
    },
    {
      "affs": [
        1
      ],
      "name": "Holly O’Donnell"
    },
    {
      "affs": [
        2
      ],
      "name": "Matthew Schmidt"
    },
    {
      "affs": [
        3
      ],
      "name": "Jessica C. Kichler"
    },
    {
      "affs": [
        0
      ],
      "name": "Laura B. Smith"
    },
    {
      "affs": [
        4
      ],
      "name": "Sarah C. Westen"
    },
    {
      "affs": [
        5
      ],
      "name": "Laura Jacobsen"
    },
    {
      "affs": [
        6
      ],
      "name": "Sarah D. Corathers"
    },
    {
      "affs": [
        0
      ],
      "name": "Desireé N. Williford"
    },
    {
      "affs": [
        1
      ],
      "name": "Paige J. Trojanowski"
    },
    {
      "affs": [
        0
      ],
      "name": "Erin Flynn"
    },
    {
      "affs": [
        4
      ],
      "name": "Emily R. Shaffer"
    },
    {
      "affs": [
        1
      ],
      "name": "Bailey Tanner"
    },
    {
      "affs": [
        4
      ],
      "name": "Kimberly A. Driscoll"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fe976897xk8sw.bib",
  "cited_by": 1,
  "doi": "10.1016/j.jpeds.2026.115155",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13714887/",
  "id": "fe976897xk8sw",
  "issns": [
    "0022-3476",
    "1097-6833"
  ],
  "landing_url": "https://doi.org/10.1016/j.jpeds.2026.115155",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2712|Diabetes Management and Education"
    ]
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  "openalex": "W7162120935",
  "pdf_url": null,
  "pmcid": "PMC13714887",
  "pmid": "42176729",
  "published": "2026-05-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fe976897xk8sw.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:22:18Z",
      "native_id": "PMC13714887",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jpeds.2026.115155"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Management and Education",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Figure Pilot Randomized Controlled Clinical Trial to Improve Adherence Barriers for Adolescents with Type 1 Diabetes",
  "title_text": "Figure Pilot Randomized Controlled Clinical Trial to Improve Adherence Barriers for Adolescents with Type 1 Diabetes",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:18Z",
  "url": "https://research.draconitic.com/paper/fe976897xk8sw",
  "venue": "The Journal of pediatrics",
  "versions": []
}