Can A Computer Game Improve Adherence to Treatment in Children with Type 1 Diabetes?

Can A Computer Game Improve Adherence to Treatment in Children with Type 1 Diabetes? Interventions to improve compl Interventions to improve compliance in Type 1 Diabetes are limited. The aim of this research was to adapt a computer game, developed initially for patients with Inflammatory Bowel Disease (IBD), to patients with Type 1 Diabetes Mellitus (T1DM) and to determine whether this interactive application would have an effect on behavior intention and adherence to treatment in this population. Two game frameworks were created, the active intervention (E[sub]H[/sub]) which contains an embedded self [ndash]care framework which adapts to the patient[apos]s behaviour to motivate the patient and a second game framework (E[sub]O[/sub]) which does not adapt to patient behaviour. The study implemented a longitudinal cross-over design. Patients aged 7-14 were eligible. Patients were randomized to either G[sub]1[/sub] (played E[sub]H[/sub] for 3 weeks, followed by E[sub]O [/sub]for 3 weeks) or G[sub]2[/sub] (played E[sub]O[/sub] followed by E[sub]H[/sub]). The total study duration was 6 weeks. The study used a modified version of the Theory of Planned Behavior (TPB) questionnaire which was converted to behaviour intention score (BIS). Compliance with blood glucose testing and insulin administration was reported daily by a parent. Adherence rate was calculated and presented to participants daily as health points in E[sub]H[/sub]. 42 T1DM patients participated (25/42 males) with a mean age of 10.7 years. 21 were assigned to G[sub]1[/sub] (11/21 males) and 21 were assigned to G[sub]2[/sub] (14/21 males). A significant difference was seen in adherence between E[sub]H[/sub] and E[sub]O [/sub]in the first half of the study (12.86%, p=0.002) and in the second half of the study (6.71%, p=0.024). There was no effect of A1C seen on BIS in either group. This study showed that, over a short period of time, a game framework which provided positive reinforcement to recommended treatment behaviors lead to improved adherence to treatment in children with T1DM. This effect was lost or not present when the game framework did not provide positive feedback. These results are promising and provide support to the use of interactive media to promote healthy behaviors in children and adolescents with T1DM. ARATI S. MOKASHI, ANTHONY R. OTLEY, HADI KHARRAZI 1233-P Halifax, NS, Canada, Indianapolis, IN Pediatrics - Type 1 Diabetes