Mixed Methods Approach to Evaluating Barriers to Nutritional Adherence in Adolescents with Cystic Fibrosis

评估囊性纤维化青少年营养依从障碍的混合方法

• 批准号: 10300986
• 负责人: Kristine Durkin
• 金额: $ 1.37万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-15 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10300986
• 关键词: Adherence; Adolescent; Age; Area; Bacterial Infections; Behavior; Behavior Therapy; Behavioral; Behavioral Research; Behavioral Sciences; Body Image; Calories; Caring; Child; Child Health; Child Rearing; Childhood; Choices and Control; Chronic; Chronic Disease; Clinic; Clinic Visits; Clinical Research; Collaborations; Communication; Competence; Consumption; Cystic Fibrosis; Data; Development; Diet; Dietary intake; Dietitian; Disease; Dissemination and Implementation; Energy Intake; Ensure; Enzymes; Exocrine pancreatic insufficiency; Face; Fatty acid glycerol esters; Focus Groups; Food; Foundations; Future; Genetic; Goals; Health; Hour; Intake; Intervention; Interview; Joints; Learned Helplessness; Life; Link; Literature; Longevity; Lung; Malnutrition; Measures; Medical; Medical Care Team; Mentors; Methodology; Methods; Minerals; Modeling; Motivation; National Research Service Awards; Nutritional; Nutritional Support; Nutritional status; Outcome; Parents; Participant; Predictive Factor; Proteins; Provider; Public Health; Randomized Controlled Trials; Recommendation; Regimen; Regression Analysis; Reporting; Research; Research Personnel; Resources; Risk; Sampling; Self Efficacy; Site; Surveys; Teenagers; Training; Training Programs; Visit; Vitamins; Youth; base; behavior change; career; children with cystic fibrosis; cystic fibrosis patients; design; dietary; dietary supplements; experience; health literacy; improved; indexing; innovation; neglect; novel; nutrient absorption; pulmonary function; recruit; satisfaction; stakeholder perspectives; translational scientist

! PROJECT SUMMARY Adhering to dietary recommendations and nutritional supplements to deter inadequate absorption of nutrients the development of malnutrition in patients with cystic fibrosis (CF) is critical, given that nutritional status is significantly related to health outcomes (e.g., lung functioning) and longevity. Yet, non-adherence to the CF care regimen, including nutritional recommendations, is high in adolescents, in particular. Though behavioral interventions have been very effective in improving nutritional intake in young children with CF, little is known about what factors are associated with nutritional non-adherence in adolescents with CF. With increased independence and control over dietary intake, adolescents likely have adherence challenges that are different than their younger counterparts. Therefore, using a [convergent mixed methods design], the overall goal of this study is to identify factors related to adherence to nutritional recommendations in adolescents with CF and to obtain rich qualitative data from key stakeholders (i.e., adolescents & dietitians) regarding barriers to nutritional adherence and challenges in working together in clinic to improve it. We will apply an organizing framework, the Capability-Opportunity-Motivation-Behavior (COM-B) model, to interpret our findings and identify specific factors necessary for behavior change in future interventions. This study is innovative, as no other behavioral research has focused on understanding adolescent-specific challenges to nutritional adherence in the CF care regimen. [A total of 132 adolescents (ages 12-18) will be recruited from 5 CF centers across the US to obtain a sample of at least 110 adolescents after possible attrition]. For Specific Aim 1, adolescents will complete surveys measuring a range of potential factors associated with adherence, as well as 2 random days of 24-hour diet recall to indirectly assess nutritional adherence through the CF-INTAKE measure (daily caloric intake, fat grams, enzyme use, number of meals & snacks). Regression analyses will examine which factors significantly predict nutritional adherence scores. For Specific Aim 2, 20 adolescents will be randomly selected from the larger sample to provide in-depth stakeholder perspectives on the difficulties they experience around nutritional adherence. Six dietitians (from our 5 recruitment sites) also will take part in [focus groups] to share their perspective on challenges they experience in communicating with and supporting adolescents on nutritional adherence. Qualitative results will be integrated with quantitative findings for final analysis [using a comparison joint display table]. Results from this NRSA project are expected to provide better understanding of behavioral determinants for adolescent nutritional non-adherence so that a developmentally-sensitive, yet practical, clinic-based adherence promotion intervention can be developed to target these factors in the future. ! !

呢 项目摘要 坚持饮食建议和营养补充剂，以阻止营养吸收不足 鉴于营养状况为 与健康结果（例如肺功能）和寿命显着相关。然而，不遵守CF 尤其是青少年，包括营养建议在内的护理方案，包括营养建议。虽然行为 干预措施在改善CF的幼儿的营养摄入量方面非常有效，鲜为人知 关于哪些因素与CF青少年的营养不遵守有关。增加 独立性和对饮食摄入的控制，青少年可能会面临遵守挑战 与年轻的对应者不同。因此，使用[收敛混合方法设计]，总体 这项研究的目标是确定与青少年遵守营养建议有关的因素 使用CF，并从关键利益相关者（即青少年和营养师）那里获取丰富的定性数据 营养依从性和在诊所共同努力改善它的障碍。我们将应用 组织框架，功能 - 运动动机行为（COM-B）模型，以解释我们 发现并确定未来干预措施行为改变所需的特定因素。这项研究是 创新的，因为没有其他行为研究专注于理解青少年特定的挑战 CF护理方案中的营养依从性。 [总共将招募132名青少年（12-18岁） 5个CF中心在美国各地获得至少110名青少年的样本]。为了 特定目标1，青少年将完成测量与一系列潜在因素的调查 依从性以及24小时饮食的2天随机召回，间接评估营养依从性 CF-Intake量度（每日热量摄入，脂肪克，酶的使用，餐和小吃数）。 回归分析将检查哪些因素可以显着预测营养依从性评分。为了 特定的目标2，20名青少年将随机从较大的样本中随机选择，以提供深入 利益相关者对他们在营养依从性方面遇到的困难的看法。六位营养师（来自 我们的5个招聘站点）还将参加[焦点小组]，分享他们对他们的挑战的看法 在与营养依从性方面与青少年进行交流和支持的经验。定性结果 将与定量发现集成以进行最终分析[使用比较关节显示表]。结果 从这个NRSA项目中，预计将更好地理解对行为决定因素的理解 青少年营养不遵守，以便具有发育敏感但实用的诊所 可以开发依从性促进干预措施以针对这些因素。 呢 呢