Feasibility and acceptability of a mother-­daughter intervention to address disordered eating behavior among adolescent girls living with type 1 diabetes mellitus

Abstract

Disordered eating behavior (DEB) is an important health problem among adolescent girls in the United States. DEB has been correlated with the subsequent development of clinically diagnosed eating disorders and with other psychological illnesses. Adolescent females with Type-­1diabetes (T1DM) are at higher risk for DEB and have a two-­fold higher incidence of disordered eating behavior (DEB) than their non-­diabetic counterparts. Individuals with T1DM have the unique ability to omit insulin as a weight reduction strategy. DEB in T1DM adolescent females significantly increases the risk for premature nephropathy, neuropathy, retinopathy, and death. Despite strong evidence to support the association between DEB and negative health outcomes, little research has focused on interventions that lower the risk of DEB among adolescent girls with T1DM. The purpose of this study was to develop and test the feasibility and acceptability of a mother-­daughter intervention to address three of the major risk factors for DEB: low self-­esteem, poor body image, and maternal-­ daughter communication. Participants in this study were ten mother-­daughter dyads for a total of 20 participants (n = 20). Intervention development was guided by feminist, cognitive behavioral, and current diabetic theoretical frameworks and input from a mother-­daughter dyad with the daughter having T1DM. Data was collected from participants on intervention effectiveness and overall acceptability. Feasibility and acceptability of the intervention was high in both mothers and daughters. Positive gains noted by participants included increased knowledge of mother-­daughter communication, self-­esteem, and deciphering media messages. Participants' goals after intervention included improved communication at home, increased scrutiny of media messages, and improved diabetes care. A pre/post-­test design was utilized to examine changes in depression, self-­esteem, body image, mother-­daughter relationship, and disordered eating risk from pre to post-­intervention. Encouraging changes in the clinically desired direction were seen on body image and disordered eating risk post-­intervention. The next step in this program of research is to refine the intervention and then conduct a controlled pilot study with a larger sample size.