# The Promoting Resilience in Stress Management (PRISM) Intervention: a multisite randomized control trial in adolescents with Type 1 Diabetes

> **NIH NIH R01** · SEATTLE CHILDREN'S HOSPITAL · 2021 · $566,327

## Abstract

PROJECT SUMMARY
Adolescents with type 1 diabetes (T1D) are at high risk for elevated diabetes distress, which greatly impacts
their adherence, glycemic control (A1C), and overall quality of life (QOL). A potential barrier to improving these
experiences may be that adolescents have few opportunities to develop the personal resources needed to
handle adversity and manage stress. The “Promoting Resilience in Stress Management” (PRISM) intervention
is a manualized, brief, skills-based intervention delivered in 2, 45-60 minute one-on-one sessions, followed by
a family meeting and supplemented by booster sessions and a digital app. PRISM was developed from Stress
and Coping theory and targets skills in stress-management and mindfulness, goal-setting, positive reframing,
and meaning-making. All of these skills are associated with improved patient outcomes in diverse groups of
adolescent populations with chronic/serious illness, and findings from a feasibility trial in adolescents with T1D
showed PRISM to be highly feasible and desirable in this population. Further, a recent pilot randomized
controlled trial among adolescents with cancer suggest PRISM is associated with improved perceptions of
resilience, lower psychological distress, and higher QOL. This application proposes to build on our prior
experience and fill three critical knowledge gaps: (1) PRISM’s impact on A1C among adolescents with T1D; (2)
PRISM’s impact on diabetes distress, self-reported adherence, and other patient-reported outcomes including
resilience and QOL; and (3) the cost-effectiveness of PRISM compared to usual care in a prospective
economic analysis. This funding opportunity seeks to test interventions targeting diabetes distress for impact
on glycemic control. Thus, we propose a multi-site randomized controlled trial among N=120 adolescents
(n=60 PRISM, n=60 Usual Care; ages 13-18) with the primary trial outcome of glycemic control 6-months post-
enrollment. Time-in-range will be evaluated for participants on continuous glucose monitors as an exploratory
aim. Secondary outcomes will include diabetes-distress, and patient-reported adherence, resilience, and
quality of life. Cost-effectiveness will also be assessed to address the potential for sustainability and
dissemination. We hypothesize PRISM will promote better glycemic control, improved diabetes distress, and
be more cost-effective than usual care. This application offers an opportunity to expand the body of knowledge
regarding methodologically rigorous and evidence-based interventions for adolescents with T1D. Ultimately,
this research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for
this high-risk group.

## Key facts

- **NIH application ID:** 10135933
- **Project number:** 5R01DK121224-03
- **Recipient organization:** SEATTLE CHILDREN'S HOSPITAL
- **Principal Investigator:** Joyce P Yi-Frazier
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $566,327
- **Award type:** 5
- **Project period:** 2019-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10135933

## Citation

> US National Institutes of Health, RePORTER application 10135933, The Promoting Resilience in Stress Management (PRISM) Intervention: a multisite randomized control trial in adolescents with Type 1 Diabetes (5R01DK121224-03). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10135933. Licensed CC0.

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