Grant Application

Marilyn Clougherty, RN, MSN, CDE, Children’s Hospital of Pittsburgh of UPMC, in partnership with Linda Siminerio, RN, PhD, CDE, and Jodi Krall, PhD, at the University of Pittsburgh Diabetes Institute

Proposed Innovation

Diabetes is one of the most common diseases in children, requiring constant parental management and decision-making. As adolescents with diabetes transition into adulthood, however, they need to begin taking greater responsibility for their own care. This transition can be challenging for patients and parents, leading to poor metabolic control and compromised quality of life.

This project was designed to fill a void by providing age-appropriate training to young patients during their adolescent years to help them make informed decisions about their health and lifestyle choices. PREP-Care (Pediatric Resources to Engage Patients in their Diabetes Care) tools engaged adolescent patients in making decisions about their care using visual aids, diabetes risk and self-care assessments, and goal-setting and planning forms.


Diabetes educators used PREP-Care during clinic visits to teach young patients about the risks and consequences of poor glycemic control. The goal was to improve their knowledge, skills, and confidence, enabling them to take increasing control of their own condition and integrate effective self-management into their daily lives.

Thirty-one adolescent patients with diabetes (ages 14 to 18) were recruited to participate in the PREP-Care project through three clinic visits over a six-month period. The project was evaluated after six months to assess the impact on glucose control, diabetes self-management, and satisfaction.


Seventy percent of those patients who completed the project improved or maintained glucose control over the six-month period. At six months, lower hemoglobin A1c (HbA1c) correlated with higher patient- and parent-rated self-efficiency for diabetes management. Over 7 percent of participants agreed that PREP-CARE helped them learn more about diabetes, the importance of controlling glucose, and setting goals. In addition, a majority of the patients said the project provided a forum for discussion; while parents said it helped them to better understand their child’s concerns.