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. 2021 Dec 20;2021(12):CD010618. doi: 10.1002/14651858.CD010618.pub2

Boogerd 2017.

Study characteristics
Methods Randomised controlled trial; wait list control
Participants 189 parents of children aged under 13 years with type 1 diabetes initially agreed to participate. Forty‐seven parents dropped out before filling out the final questionnaire, leaving N=105 in total (54 in intervention, 51 in control).
Interventions Online parent support group with facilitator
Online peer support facilitated through a chat application, a forum, and a blog. Parents and health professionals communicate in real time via the chat app. Parents and professionals can read and post messages on the forum. Nurse practitioners moderate the forum daily and answer questions via the app.
OTHER COMPONENTS:
1. Information sharing relating to treatment goals between parent and relevant professionals (private, 1‐to‐1)
2. Downloadable documents and web links
Care as usual:
This included multidisciplinary care provided by a team of pediatric diabetologists, diabetes nurse practitioners, dietitians, and psychologists. Pediatric diabetologists and nurse practitioners were seen 4x per year. Dieticians and psychologists were available on request, or by referral from the treating team. The care team was contactable during business hours by all parents, and an emergency line was set up for after hours use.
Participants in the experimental group received both the online parent support group and care as usual. The control group received only care as usual.
Outcomes Primary
  • Feasibility of RCT to measure Sugarsquare: number of potential participants, the proportion of parents who refused participation, and the attrition rates.


Secondary
  • Feasibility of implementing Sugarsquare in terms of

    • practicability, acceptability, demand, and integration into practice

    • potential efficacy in reducing parental stress (Parenting Stress Index PSI‐SF): self‐report measure including 25 items, answered on a 6‐point Likert scale (totally agree to totally disagree) Scores are summed. A higher score indicates higher stress. Standardised scores provided in the manual (not detailed in study) indicate normal, subclinical, or clinical levels of stress Reitman 2002.


Measured at baseline and 6 months following baseline. Protocol also mentions a 12 month follow‐up but this was not reported.
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Random sequence generation conducted by independent researcher. Random sequence of red/green cards used to allocate (colour cannot be discerned prior to allocation)
Allocation concealment (selection bias) High risk Authors state “when participants have sent back their filled out baseline questionnaire, they are informed about the allocation”. Control is wait‐list so allocation would in any case be problematic
Blinding of participants and personnel (performance bias)
All outcomes High risk Authors state “this study is not blinded”.
Blinding of outcome assessment (detection bias)
All outcomes High risk Self‐report (measure of interest, parenting stress). Site use metrics and child health outcomes derived from computer and medical files.
Incomplete outcome data (attrition bias)
All outcomes Low risk Attrition is well reported across the life of the study. Some reasons suggested, and attempts made to assess extent of and reasons for incompleteness (likely because this is a feasibility study and they are trying to determine what attrition to expect in a full study).
Selective reporting (reporting bias) Low risk All outcomes seem to have been reported, regardless of whether they showed a significant difference between intervention and control.
Other bias Low risk None apparent