Increasing the adherence of diabetic adolescents

This study examined the effects of sequentially introducing self-monitoring, goal setting, and behavioral contracting procedures on increasing the regimen compliance of nonadherent adolescent diabetics. For each of three insulin-dependent subjects, a multiple-baseline across-behaviors design was used to study three of the following target behaviors: urine testing, insulin injections, exercise, wearing diabetic identification, and home blood glucose testing. In addition to self-monitoring of adherence, measures of metabolic control of diabetes were collected before and after an 8-week treatment and at a 2-month follow-up. Adherence increased and was maintained at desired levels for two of the subjects following introduction of goal setting procedures. Metabolic control measures also showed substantial improvement for these subjects. The third subject, whose family was experiencing a variety of severe problems, did not show reliable improvement. The data suggest that graduated goal setting is a promising approach for improving adherence to diabetic regimens.