Psychosocial interventions and health-related quality of life in children and adolescents with type 1 diabetes: a systematic review and meta-analysis.

Purpose. To synthesize evidence on the effectiveness of psychosocial interventions in improving health-related quality of life (HRQoL) in children and adolescents with type 1 diabetes (T1D), and to characterize their theoretical foundations, core components, therapeutic targets, and delivery features.Methods. Systematic review and meta-analysis following PRISMA 2020, prospectively registered in PROSPERO (CRD420261349366). Searches of PubMed/MEDLINE, Web of Science, EBSCO, and SCOPUS identified randomized controlled trials published between 2011 and March 2026 evaluating psychosocial interventions in youth (≤18 years) with T1D reporting at least one HRQoL outcome. Two independent reviewers conducted screening, data extraction, and quality appraisal using the NHLBI tool. Interventions were coded using the Theory Coding Scheme. A random-effects meta-analysis (Hedges' g) pooled trials with inactive comparators.Results. Twelve reports (11 independent RCTs; 2,082 randomized participants) were included. Interventions shared core components (psychoeducation, coping and problem-solving skills, communication and family engagement, and motivational and self-management strategies) despite diverse theoretical traditions. Meta-analysis of five trials (752 participants) demonstrated a small but statistically significant HRQoL improvement compared with inactive controls (Hedges' g = 0.24; 95% CI 0.10–0.38; p = .001; I² = 0%). Improvements in emotional well-being, family functioning, and self-management were more consistent than metabolic gains.Conclusions. Psychosocial interventions produce reliable though modest HRQoL improvements in children and adolescents with T1D. Theory was used descriptively rather than to test mechanisms. Future trials should designate HRQoL as a primary endpoint and formally test hypothesized mechanisms of change.