{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:47:00Z","timestamp":1785390420502,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Diabetes and Digestive and Kidney Diseases","award":["1R01DK118514"],"award-info":[{"award-number":["1R01DK118514"]}]},{"name":"National Institutes of Diabetes and Digestive and Kidney Diseases","award":["NCT3914547"],"award-info":[{"award-number":["NCT3914547"]}]},{"name":"Clinical trial","award":["1R01DK118514"],"award-info":[{"award-number":["1R01DK118514"]}]},{"name":"Clinical trial","award":["NCT3914547"],"award-info":[{"award-number":["NCT3914547"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objectives: Severe hypoglycemia is more common among young children with type 1 diabetes mellitus (T1DM) than older youth, and parents report significant hypoglycemia fear (HF). Parents experiencing HF describe constant and extreme worry about the occurrence of hypoglycemia and may engage in potentially risky behaviors to avoid hypoglycemia. Our team developed and tested a behavioral intervention, Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), to decrease HF in parents of young children with T1DM. Here, we qualitatively analyzed parent feedback to refine and optimize future intervention iterations. Methods: The randomized pilot study included parents (n = 73) of young children with T1DM who participated in the 10-session video-based intervention. We qualitatively analyzed 21 recordings of the final intervention session, where parents provided feedback about intervention content. Trained coders independently reviewed each session. The frequency of parent quotes regarding active REDCHiP treatment components were calculated. Results: The coded themes reflected active treatment components [viz., Use of Cognitive Behavioral Therapy (CBT) Skills, Coping, Behavioral Parenting Strategies]. Also, two secondary process codes were identified: Appreciate REDCHiP Content and Challenges in Applying REDCHiP Strategies. Parents provided examples of skills or concepts they applied from REDCHiP, the challenges they encountered, and if they planned to apply these skills in the future. Conclusions: A qualitative analysis provided insight into parent perceptions of the active treatment components within the REDCHiP intervention, their acceptability, and parents\u2019 intention to apply REDCHiP skills\/concepts within daily T1DM cares. Future iterations of the intervention that trial alternative formats (i.e., individual vs. group and asynchronous vs. telehealth) may increase accessibility and scalability.<\/jats:p>","DOI":"10.3390\/children12030360","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T07:02:16Z","timestamp":1741935736000},"page":"360","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Parent Feedback on the Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP) Intervention: A Qualitative Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7973-2153","authenticated-orcid":false,"given":"Nicole A.","family":"Kahhan","sequence":"first","affiliation":[{"name":"Division of Psychology, Nemours Children\u2019s Health-Jacksonville, 807 Children\u2019s Way, Jacksonville, FL 32207, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9244-9478","authenticated-orcid":false,"given":"MaryJane S.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Center for Healthcare Delivery Science\u2013Florida, Nemours Children\u2019s Health-Orlando, 13535 Nemours Pkwy, Orlando, FL 32827, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Clements","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Children\u2019s Mercy Hospital, 2401 Gillham Road, Kansas, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3006-4633","authenticated-orcid":false,"given":"Kimberly A.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology, University of Florida, 1225 Center Drive, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7955-319X","authenticated-orcid":false,"given":"Amy I.","family":"Milkes","sequence":"additional","affiliation":[{"name":"Center for Healthcare Delivery Science\u2013Florida, Nemours Children\u2019s Health-Jacksonville, 807 Children\u2019s Way, Jacksonville, FL 32207, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7774-7220","authenticated-orcid":false,"given":"Holly K.","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Barbara Davis Center for Diabetes, School of Medicine, University of Colorado, 1775 Aurora Ct., Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8902-6965","authenticated-orcid":false,"given":"Susana R.","family":"Patton","sequence":"additional","affiliation":[{"name":"Center for Healthcare Delivery Science\u2013Florida, Nemours Children\u2019s Health-Jacksonville, 807 Children\u2019s Way, Jacksonville, FL 32207, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1001\/jama.2021.11165","article-title":"Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001\u20132017","volume":"326","author":"Lawrence","year":"2021","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee 14 (2024). Children and Adolescents: Standards of Care in Diabetes\u20142025. Diabetes Care, 48, S283\u2013S305.","DOI":"10.2337\/dc25-S014"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S121","DOI":"10.2337\/dc08-s228","article-title":"Hypoglycemia in Type 1 Diabetes","volume":"31","author":"Shalitin","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s11892-014-0520-2","article-title":"Young Children with Type 1 Diabetes: Challenges, Research, and Future Directions","volume":"14","author":"Streisand","year":"2014","journal-title":"Curr. Diabetes Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.2337\/db10-0103","article-title":"Hypoglycemia in Type 1 Diabetes","volume":"59","author":"McCrimmon","year":"2010","journal-title":"Diabetes"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kimbell, B., Lawton, J., Boughton, C., Hovorka, R., and Rankin, D. (2021). Parents\u2019 Experiences of Caring for a Young Child with Type 1 Diabetes: A Systematic Review and Synthesis of Qualitative Evidence. BMC Pediatr., 21.","DOI":"10.1186\/s12887-021-02569-4"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1093\/jpepsy\/jsi076","article-title":"Pediatric Parenting Stress Among Parents of Children with Type 1 Diabetes: The Role of Self-Efficacy, Responsibility, and Fear","volume":"30","author":"Streisand","year":"2005","journal-title":"J. Pediatr. Psychol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s10880-008-9123-x","article-title":"Fear of Hypoglycemia in Parents of Young Children with Type 1 Diabetes Mellitus","volume":"15","author":"Patton","year":"2008","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s11892-016-0762-2","article-title":"Fear of Hypoglycemia in Children and Adolescents and Their Parents with Type 1 Diabetes","volume":"16","author":"Driscoll","year":"2016","journal-title":"Curr. Diabetes Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1093\/jpepsy\/jsu068","article-title":"Understanding the Construct of Fear of Hypoglycemia in Pediatric Type 1 Diabetes","volume":"39","author":"Shepard","year":"2014","journal-title":"J. Pediatr. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/pedi.13150","article-title":"Fear of Hypoglycemia in Children with Type 1 Diabetes and Their Parents: Effect of Pump Therapy and Continuous Glucose Monitoring with Option of Low Glucose Suspend in the CGM TIME Trial","volume":"22","author":"Verbeeten","year":"2021","journal-title":"Pediatr. Diabetes"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/pedi.12525","article-title":"Nighttime Is the Worst Time: Parental Fear of Hypoglycemia in Young Children with Type 1 Diabetes","volume":"19","author":"Hilliard","year":"2018","journal-title":"Pediatr. Diabetes"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1464-5491.2009.02867.x","article-title":"Fear of Hypoglycaemia in Mothers and Fathers of Children with Type 1 Diabetes Is Associated with Poor Glycaemic Control and Parental Emotional Distress: A Population-Based Study","volume":"27","author":"Haugstvedt","year":"2010","journal-title":"Diabet. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/j.1399-5448.2007.00242.x","article-title":"Parental Fear of Hypoglycemia: Young Children Treated with Continuous Subcutaneous Insulin Infusion","volume":"8","author":"Patton","year":"2007","journal-title":"Pediatr. Diabetes"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1007\/s00125-010-1706-z","article-title":"The Shape of the Metabolic Memory of HbA1c: Re-Analysing the DCCT with Respect to Time-Dependent Effects","volume":"53","author":"Lind","year":"2010","journal-title":"Diabetologia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.2337\/dc20-3097","article-title":"Understanding Metabolic Memory: The Prolonged Influence of Glycemia During the Diabetes Control and Complications Trial (DCCT) on Future Risks of Complications During the Study of the Epidemiology of Diabetes Interventions and Complications (EDIC)","volume":"44","author":"Lachin","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1037\/hea0000161","article-title":"From Ideas to Efficacy: The ORBIT Model for Developing Behavioral Treatments for Chronic Diseases","volume":"34","author":"Czajkowski","year":"2015","journal-title":"Health Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e17877","DOI":"10.2196\/17877","article-title":"Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP): Protocol for a Randomized Clinical Trial to Test a Video-Based Telehealth Intervention","volume":"9","author":"Patton","year":"2020","journal-title":"JMIR Res. Protoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1186\/s13063-019-3876-4","article-title":"A Cognitive Behavioral Therapy Intervention to Reduce Fear of Hypoglycemia in Young Adults with Type 1 Diabetes (FREE): Study Protocol for a Randomized Controlled Trial","volume":"20","author":"Duffecy","year":"2019","journal-title":"Trials"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"637","DOI":"10.2337\/diacare.24.4.637","article-title":"Blood Glucose Awareness Training (BGAT-2): Long-Term Benefits","volume":"24","author":"Cox","year":"2001","journal-title":"Diabetes Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/pedi.12791","article-title":"Graduated Exposure to Treat Fear of Hypoglycemia in a Young Adult with Type 1 Diabetes: A Case Study","volume":"20","author":"Berget","year":"2019","journal-title":"Pediatr. Diabetes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"166","DOI":"10.2337\/ds20-0058","article-title":"Parent Perspectives on Educational and Psychosocial Intervention for Recent-Onset Type 1 Diabetes in Their School-Age Child: A Qualitative Study","volume":"34","author":"Marker","year":"2021","journal-title":"Diabetes Spectr."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/3\/360\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:53:36Z","timestamp":1760028816000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/3\/360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,14]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["children12030360"],"URL":"https:\/\/doi.org\/10.3390\/children12030360","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,14]]}}}