Effectiveness of resilience-promoting interventions in adolescents with diabetes mellitus: a systematic review and meta-analysis

BACKGROUND: This study aimed to analyze the efficacy of resilience-promoting interventions among adolescents and youth aged 10–24 years with any type of diabetes. METHODS: A systematic literature search was performed using the PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and PsycINFO databases from inception to May 25, 2022. The Cochrane risk of bias tool (version 2) was used to assess the quality of the included studies. A meta-analysis was performed to calculate the pooled effects of resilience-promoting interventions. RESULTS: Nineteen articles were included covering an overall sample of 2048 adolescents with diabetes. When analyzing the effectiveness of resilience-promoting interventions, hemoglobin A1c (HbA1c) at six months [mean difference = − 0.47, 95% confidence interval (CI) = − 0.83 to − 0.12, P = 0.009] after the intervention was improved. However, long-term (≥ 12 months) improvement in HbA1c was not significant. In addition, comparing the control group, there were significant differences in the effect size for stress [standardized mean difference (SMD) = − 0.87, 95% CI = − 1.25 to -0.48, P < 0.05], self-efficacy (SMD = 0.50, 95% CI = 0.02–0.98, P = 0.04) and quality of life (SMD = 0.27, 95% CI = 0.03–0.51, P = 0.03). CONCLUSIONS: Resilience-promoting intervention is a promising way for adolescent diabetes management to improve HbA1c, stress, self-efficacy, and quality of life. Incorporating resilience-promoting components into diabetes education and re-enforcing these contents every six months are recommended for implementation in clinical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12519-022-00666-7.