J. Med. Internet Res. - Type 1 diabetes eHealth psychoeducation: youth recruitment, participation, and satisfaction.


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CKGROUND: The Internet and other eHealth technologies offer a platform for improving the dissemination and accessibility of psychoeducational programs for youth with chronic illness. However, little is known about the recruitment process and yield of diverse samples in Internet research with youth who have a chronic illness.OBJECTIVE: The purpose of this study was to compare the demographic and clinical characteristics of youth with Type 1 diabetes on recruitment, participation, and satisfaction with 2 eHealth psychoeducational programs.METHODS: Youth with Type 1 diabetes from 4 sites in the United States were invited to participate (N=510) with 320 eligible youth consenting (mean age=12.3, SD 1.1; 55.3% female; 65.2% white; and mean A1C=8.3, SD 1.5). Data for this secondary analysis included demographic information (age, race/ethnicity, and income), depressive symptoms, and recruitment rates, including those who refused at point of contact (22.0%), passive refusers who consented but did not participate (15.3%), and those who enrolled (62.7%). Participation (80% lessons completed) and a satisfaction survey (ie, how helpful, enjoyable) were also analyzed. Chi-square or analysis of variance (ANOVA) analyses were used.RESULTS: There were significant differences in recruitment rates by income and race/ethnicity such that black, Hispanic, or mixed race/ethnicity and low-income youth were more likely to refuse passively compared to white and higher-income youth who were more likely to enroll (P<.001). Participation in program sessions was high, with 78.1% of youth completing at least 4 of 5 sessions. There were no significant differences in participation by program, age, gender, or race/ethnicity. Low-income youth were less likely to participate (P=.002). Satisfaction in both programs was also high (3.9 of 5). There were significant gender, race/ethnicity, and income differences, in that girls (P=.001), black, Hispanic, or mixed race/ethnicity youth (P=.02), and low-income youth (P=.02) reported higher satisfaction. There were no differences in satisfaction by program or age.CONCLUSIONS: Results indicate that black, Hispanic, or mixed race/ethnicity youth and low-income youth with Type 1 diabetes are less likely to enroll in Internet-based research than white and higher-income youth; thus, creative recruitment approaches are needed. Low-income youth were less likely to participate, possibly due to access. However, once enrolled, youth of diverse race/ethnicity and low-income youth with Type 1 diabetes were as highly satisfied with the eHealth programs as white youth and those with higher income. Results suggest that eHealth programs have the potential to reach diverse youth and be appealing to them.

Resumo Limpo

ckground internet ehealth technolog offer platform improv dissemin access psychoeduc program youth chronic ill howev littl known recruit process yield divers sampl internet research youth chronic illnessobject purpos studi compar demograph clinic characterist youth type diabet recruit particip satisfact ehealth psychoeduc programsmethod youth type diabet site unit state invit particip n elig youth consent mean age sd femal white mean ac sd data secondari analysi includ demograph inform age raceethn incom depress symptom recruit rate includ refus point contact passiv refus consent particip enrol particip lesson complet satisfact survey ie help enjoy also analyz chisquar analysi varianc anova analys usedresult signific differ recruit rate incom raceethn black hispan mix raceethn lowincom youth like refus passiv compar white higherincom youth like enrol p particip program session high youth complet least session signific differ particip program age gender raceethn lowincom youth less like particip p satisfact program also high signific gender raceethn incom differ girl p black hispan mix raceethn youth p lowincom youth p report higher satisfact differ satisfact program ageconclus result indic black hispan mix raceethn youth lowincom youth type diabet less like enrol internetbas research white higherincom youth thus creativ recruit approach need lowincom youth less like particip possibl due access howev enrol youth divers raceethn lowincom youth type diabet high satisfi ehealth program white youth higher incom result suggest ehealth program potenti reach divers youth appeal

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