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Clinical Child and Pediatric Psychology Department of Clinical and Health Psychology - College of public health and health professions
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Research Overview

Dr. Sarah Westen’s Publications

Contributions to T1D science focus on the following areas. Select publications are presented.

The assessment of type 1 diabetes adherence and associated psychological factors is of particular interest to me. Type 1 diabetes is diagnosed in 1 in 500 children in the United States and poses unique challenges to adherence-related behavior due to complex daily treatment regimens critical to offsetting healthcare costs and reducing morbidity and mortality. However, there is a research gap to examine diabetes-specific psychological factors in youth (e.g., fear of hypoglycemia, insulin restriction for the purpose of weight control, diabetes burn-out) and their role in predicting adherence as measured by daily-downloaded data from diabetes technology (e.g., an insulin pump).

  1. Westen, S. C., Warnick, J. L., Albanese-O’Neill, A., Schatz, D., Haller, M. J., Entessari, M., & Janicke, D. (2019). Objectively measured adherence in adolescents with type 1 diabetes on multiple daily injections and insulin pump therapy. Journal of Pediatric Psychology, 44(1), 21-31.
  2. Westen, S. C. (2017, embargoed). Adherence in youth with type 1 diabetes on multiple daily injections and insulin pump therapy and associated psychological factors (Doctoral dissertation). ProQuest Dissertations and Theses database.
  3. Westen, S. C., Sanders, K., Warnick, J., Gillen, S., Albanese-O’Neill, A., Haller, M., Schatz, D., & Janicke, D. M. (2017). Parent fear of hypoglycemia predicts frequency of adolescent blood glucose monitoring (Abstract). American Diabetes Association 77th Scientific Sessions 2017, San Diego, CA. Diabetes, 66(Suppl. 1), A219. June, 2017.
  4. Westen, S. C., Warnick, J., Entessari, M., Albanese-O’Neill, A., Schatz, D., Haller, M., & Janicke, D. (in press). Insulin Restriction Linked to Reduced Self-Monitoring of Blood Glucose in Adolescents with Type 1 Diabetes (Abstract). Society of Pediatric Psychology Annual Conference, Orlando, FL, April 2018.

Psychosocial screening in pediatric diabetes clinics is of critical importance to me as a researcher and clinician. I am interested in improving and implementing psychosocial screening in pediatric diabetes clinics given the increased prevalence of a variety of mental health conditions in youth with type 1 diabetes (T1D). I have collaborated with Vanderbilt University, Stanford University, Children’s National Medical Center, Cincinnati Children’s Medical Center, and the University of Colorado at Denver to combine findings of universal depression screening in pediatric diabetes clinics. In addition, I was a Co-Investigator on two University of Florida-led protocols on psychosocial screening in youth with T1D and their caregivers.

  1. Mulvaney, S. A., Mara, C. A., Kichler, J. C., Majidi, S., Driscoll, K. A., Westen, S. C., Rawlinson, A., Jacobsen, L. M., Adams, R. N., Hood, K. K., & Monaghan, M. (Epub ahead of print). A retrospective multisite examination of depression screening practices, scores, and correlates in pediatric diabetes care. Translational Behavioral Medicine.
  2. Westen, S. C., Balkhi, A., Olsen, B., Janicke, D. M., & Geffken, G. R. (2016, April). Behavioral health screening and intervention in pediatric diabetes clinics: Provider perspectives and attitudes regarding the role of psychology and psychology trainees. In D. Duke & S. Patton (Chairs), Diabetes clinical roundtable discussion: Behavioral health screening protocols for clinics. Talk to be presented at the annual meeting of the Society of Pediatric Psychology, American Psychological Association Division 54, Atlanta, Georgia.
  3. Westen, S. C. (2012). Counseling with special populations: Teenagers and adolescents. In Jim Rogers and David Lester (Eds.), Crisis Intervention and Counseling by Telephone (and the Internet) (3rd). Springfield: Charles C Thomas Publisher, Ltd.

Diabetes education, telehealth, and mobile technology is an emerging area of clinical research in type 1 diabetes. I am a Co-Investigator on a study titled “Extension for Community Health Outcomes Pilot” with Principal Investigators Dr. Michael Haller and Dr. Ashby Walker through the UF Diabetes Institute. Funded by the Helmsley Charitable Trust, the study is a provider-level intervention that aims to empower primary care providers to improve care access for underserved communities with type one diabetes through education. I am also a Co-Investigator on a study examining telehealth intervention for behavioral adherence difficulties in adolescents with type 1 diabetes (T1D) and suboptimal glycemic control. Additionally, I am interested in the transition of care from pediatric- to adult-centered models for emerging adults with type 1 diabetes, ages 18 to 25 years; and, how technology and telehealth platforms may assist with this transition process. I acted as an Expert Educator and Investigator on a study led by Dr. Anastasia Albanese-O’Neill, funded by The Bringing Science Home Initiative, which aimed to determine if a structured diabetes transition and peer support program can be delivered to these patients remotely via telehealth/videoconferencing technology.  Additionally, I was an Investigator on a study funded led by Dr. Albanese-O’Neill and funded by the American Association of Diabetes Educators and a private family foundation, which aaimed to investigate the delivery of diabetes education via mHealth (smartphone and tablet) technology to parent caregivers of youth with type 1 diabetes (T1D), with a specific focus on fathers. The outcomes we are studying included effect on diabetes knowledge, diabetes-related self-efficacy, diabetes distress, user satisfaction, and glycemic control.

 

  1. Albanese-O’Neill, A., Schatz, D.A., Thomas, N., Bernhardt, J.M., Cook, C.L., Haller, M.J., Bernier, A.V., Silverstein, J.H., Westen, S.C., & Elder, J.H. (2019). Designing Online and Mobile Diabetes Education for Fathers of Children with Type 1 Diabetes: Mixed Methods Study. JMIR Diabetes, 4(3):e13724.
  2. Albanese-O’Neill, A., Beauchamp, G., Thomas, N., Westen, S. C., Johnson, N., Schatz, D., & Haller, M. J. (2018). Transition education for young adults with type 1 diabetes: A pilot study of the feasibility of a group telehealth intervention. Journal of Medical Internet Research: Diabetes, 3(4), e10909.
  3. Balkhi, A., Reid, A., Westen, S. C., Olsen, B., Janicke, D., & Geffken, G. (2015). Teleheath interventions to reduce management complications in type 1 diabetes: A review. World Journal of Diabetes, 15:6(3), 371-379.
  4. Type 1 Diabetes Toolkit. Retrieved from http://t1dtoolkit.org/about/
  5. Warnick, J., Westen, S. C., Albanese-O’Neill, A., Schatz, D., Haller, M., & Janicke, D. (2018). Validity of Ecological Momentary Assessment compared to Self-Report to Measure Blood Glucose Monitoring Adherence in Type 1 Diabetes (Abstract). Society of Pediatric Psychology Annual Conference, Orlando, FL, April 2018.
  6. Warnick J., Westen S., Janicke D. (2017). Ecological Momentary Assessment to Measure Motivators and Barriers to Blood Glucose Monitoring in Youth with Type 1 Diabetes. (Abstract). Society of Behavioral Medicine 38th Annual Meeting & Scientific Sessions, San Diego, CA. April, 2017. Annals of Behavioral Medicine, 51, S1050-S1051.

Pediatric sleep and clinical research in lifestyle interventions is of ongoing interest to me. I assisted with an NIH-funded randomized controlled trial led by Dr. David Janicke, which aimed to examine the efficacy of cognitive behavioral treatment for child sleep (CBTcs) to address behavioral sleep issues in youth with overweight/obesity. Childhood obesity is associated with alarming health consequences and research demonstrates an association between sleep and obesity. The sleep/weight relationship is likely reciprocal as poor sleep produces hormonal and metabolic changes that predict the likelihood of later obesity, while obesity may increase the likelihood of poor sleep.

  1. Janicke, D. M., Steele, R. G., Gayes, L. A., Lim, C. S., Clifford, L. M., Schneider, E. M., Carmody, J. K., & Westen, S. C. (2014). Systematic review and meta-analysis of comprehensive behavioral family lifestyle interventions addressing pediatric obesity. Journal of Pediatric Psychology, 39(8), 809-825.
  2. Armstrong, B., Westen, S. C., Janicke, D. (2014). The role of overweight perception and depressive symptoms in child and adolescent unhealthy weight control behaviors: A mediation model. Journal of Pediatric Psychology, 39(3), 340-348.
  3. Westen, S. C., Mayer-Brown, S., Mitchell, T., & Janicke, D. M. (2014, March). Parental Feeding Concerns and Practices as Predictors of Family Mealtime Functioning (Abstract). Society of Pediatric Psychology Annual Conference, Philadelphia, PA.
  4. Westen, S. C., Stromberg, S. E., Janicke, D. M. (2015, April). The relationship between child body dissatisfaction and parent-assisted weight loss (Abstract). Society of Pediatric Psychology Annual Conference, San Diego, CA.