Abstract
Occupation-based coaching is a collaborative, family-centered intervention which can empower caregivers of children with type 1 diabetes to establish independence with diabetes management. A RCT involving telehealth occupation-based coaching intervention was piloted with rural-dwelling caregivers with a child (2-12 years) diagnosed with type 1 diabetes. Ten caregivers received 1-hour weekly sessions across 12 weeks, which were digitally recorded and transcribed verbatim. Of the 12 sessions, two sessions/transcripts were randomly selected from each of the beginning, middle, and end phases per family. The average word count and rating at each phase were calculated and repeated measures ANOVA were used to evaluate how problem-solving progressed during the coaching sessions. Analyzing a total of 60 transcripts/sessions, we found that the percentage of parent mean word count increased significantly from 67.2 at the beginning to 67.9 at middle phase and then increased to 72.4 at the end (p=0.034) demonstrating a significant linear trend (p=0.019) . The percentage of interventionist word count significantly decreased from beginning to end phases (beginning: Mean=32.8, SD=15.0; middle: Mean=32.1, SD=17.8; end: Mean=27.6, SD=12.9, p=0.034) and showed significant linear trend (p=0.019) . Average rating on the Evidence of Independent Capacity Rating Scale where "A" indicates high level of independence and "C" indicates low level of independence from the interventionist improved significantly from a rating close to B and rating of B at the beginning and middle phases, respectively, and continued to improve to a rating close to A at the end phrase (p<0.001) ; significant linear trend of improvement was also noted (p<0.001) . Preliminary evidence suggests that occupation-based coaching supports rural-dwelling families to develop problem-solving skills and autonomy in caring for their child diagnosed with type 1 diabetes.