Browsing by Author "Wolfe, Kristin Linette"
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Item Adherence as a Mediating Variable Between Depression and Health Outcomes in Adolescents with Type 1 Diabetes(2013-12-30) Wolfe, Kristin Linette; Wiebe, Deborah J.; Kennard, Beth D.; Germann, JulieAdolescence is often a time of diabetes mismanagement and poor metabolic control in adolescents with type 1 diabetes. Symptoms of depression are related to poor metabolic control, but the mechanism that links them is under debate. Because depression tends to be associated with poorer adherence and poor adherence has been shown to be related to poor metabolic control, it is possible that adherence serves as a mediator between the two. The present study tested this mediation pathway in a sample of adolescents with type 1 diabetes. Participants (N=252) were recruited from endocrinology clinics in Utah during their routine diabetes clinic visits. Participants fell between the ages of 10 and 14, were able to read and write in either English or Spanish, had a diagnosis of type 1 diabetes for at least one year, and did not have a condition that would interfere with measurement completion. Participants were drawn from a larger longitudinal observational study. This study analyzed the first three time points of data, which were obtained six months apart. Demographic and illness information was obtained from self-report and participant medical files. Questionnaires were used to assess depression and adherence. Metabolic control was measured through HbA1c levels retrieved from medical records. Data were analyzed to test the mediation hypotheses. Higher levels of depression were correlated with poorer metabolic control in cross-sectional analyses at study entry, and in longitudinal analyses measured one year later. Adherence was found to be a partial mediator in cross-sectional analyses, but did not mediate changes in metabolic control across time.Item Examining the Feasibility and Acceptability of a Phone Application for Safety Planning in Youth with Suicidality(2020-08-01T05:00:00.000Z) Wolfe, Kristin Linette; Kennard, Beth D.; Brent, David; Emslie, Graham; Foxwell, Aleksandra; King, Jessica D.; Nakonezny, PaulSuicide is the second-leading cause of death in adolescents. Despite the documented efficacy of the safety plan, research has suggested that youth do not always refer to their plans when experiencing suicidal ideation. Accessibility is often cited as a primary concern. Addressing this concern in youth may mean turning to technological means, such as phone applications, to improve access and utilization. To date, there are relatively few suicide specific apps available, and even fewer that have been empirically tested. In response to this gap in the literature, BRITE was developed as a means of utilizing technology for safety planning. This study examined the feasibility and acceptability of BRITE as a stand-alone intervention in a group of 40 youth who had been recently hospitalized for suicidality. This was measured utilizing the Post-Study System Usability Questionnaire (Lucas & Spitler, 1999; Davis, 1989), an exit interview containing both qualitative and quantitative questions, and data gathered on app usage from the BRITE clinician portal. Additional exploratory analyses around efficacy of the app were conducted utilizing the Concise Health Risk Scale- Self-Report (Trivedi et al. 2011). Results from this study indicated good feasibility and acceptability of the BRITE app. The majority of participants approached for the study gave consent and were retained in the study at four-week follow-up. Most participants (85.7%) utilized the app at least once, and many (66.7%) of these participants went on to engage with app-recommended activities. Analysis showed that there was a significant improvement in pre- and post-app usage ratings of distress. Surveyed participants, on average, rated the app as helpful, accessible and useful and reported that the platform was effective for safety planning. Qualitative analyses supported the quantitative findings, and participants reported overall satisfaction with the app as a whole and its specific components. Despite feasibility and acceptability of the app, exploratory analyses did not reveal any difference in the suicide propensity or suicide risk scores between groups. These findings suggest that BRITE compares favorably to other suicide prevention apps on the market, and adds to the literature suggesting the use of technology in suicide prevention for adolescents.