Mindfulness-Based Stress Reduction in Adolescents with Type 1 Diabetes

基于正念的 1 型糖尿病青少年减压

• 批准号: 10552006
• 负责人: Kaitlyn Rechenberg
• 金额: $ 13.7万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-18 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10552006
• 关键词: 18 year old; 19 year old; Acute; Address; Adolescent; Adult; Affect; Anxiety; Behavior Therapy; Cardiovascular system; Cellular Phone; Child; Childhood; Chronic; Clinical; Clinical Investigator; Complications of Diabetes Mellitus; Conscious; Consumption; Continuous Glucose Monitor; Development; Diabetes Mellitus; Diabetic Ketoacidosis; Disease; Disease Management; Disease Outcome; Endocrinologist; Endocrinology; Evidence based intervention; Evidence based treatment; Funding; Future; Goals; Health; High Prevalence; Hour; Hypoglycemia; Incidence; Insulin-Dependent Diabetes Mellitus; International; Intervention; Interview; K-Series Research Career Programs; Kidney; Knowledge; Knowledge acquisition; Learning; Life Style; Mental Depression; Mental Health; Mentors; Methods; Mobile Health Application; Nature; Neuropathy; Nurse Practitioners; Nurses; Outcome; Peer Review; Perception; Physiological; Population; Process; Psychologist; Publications; Quality of life; Randomized, Controlled Trials; Research; Risk; Risk Reduction; Science; Self Management; Sleeplessness; Social Workers; Symptoms; Testing; Time; Training; Treatment Protocols; United States; Work; acceptability and feasibility; anxiety management; anxiety reduction; anxiety symptoms; associated symptom; behavior test; brief intervention; career; clinical practice; clinically significant; cost; data integration; design; effective intervention; evidence base; experience; feasibility testing; glycemic control; high risk population; improved; innovation; mHealth; mindfulness intervention; mindfulness-based stress reduction; prevent; programs; prototype; psychosocial; psychosocial development; skills; sustainability framework; therapy development

PROJECT SUMMARY Type 1 diabetes (T1D) is one of the most prevalent chronic conditions in adolescents in the United States, affecting approximately 1 in 400 adolescents by 18 years of age. Adolescents with T1D are at risk for acute and long-term complications, including diabetic ketoacidosis, severe hypoglycemia, and cardiovascular, renal, and neuropathic disease. Maintaining adequate glycemic control reduces the risk of these complications. Anxiety symptoms are prevalent in adolescents with T1D, occurring at approximately 2 to 3 times the rate of the general adolescent population. Anxiety symptoms are associated with out-of-range glycemic control, poor quality of life (QOL), and poor self-management. Targeted interventions to reduce anxiety symptoms will contribute to improved QOL and improved self-management of T1D and thus improved disease outcomes. Despite the high prevalence of anxiety symptoms and strong associations with diabetes-related complications, few evidence-based interventions have been adapted for this high-risk population. This proposal uses a systematic and iterative approach to adapt an evidence-based intervention for anxiety symptoms, mindfulness- based stress reduction (MBSR), specifically to meet the developmental and lifestyle needs of this population. My goal in seeking a Mentored Research Career Development Award is to acquire the knowledge, skills, and research experience necessary to become an independent clinical investigator focused on developing, implementing, and testing behavioral interventions and improving disease outcomes in adolescents with Type 1 diabetes (T1D). This proposal constructs and tests the feasibility and acceptability of an adapted MBSR mHealth application for adolescents with T1D. The specific aims of this mixed methods proposal are to: 1. Analyze qualitative interviews with 20 adolescents with T1D and conduct interviews with 10 key stakeholders (pediatric endocrinologist, pediatric endocrinology (PE) nurse practitioner, PE nurse, PE psychologist, and PE social worker) to ascertain challenges, needs, and perceptions related to anxiety management, mindfulness- based interventions, and mHealth application features.; 2. Generate an mHealth application prototype that integrates data obtained from Aim 1 to adapt MBSR specifically for adolescents with T1D; 3a. Evaluate the MBSR mHealth application prototype for engagement, feasibility, and acceptability among 40 adolescents with T1D; and 3b. Explore preliminary efficacy of the adapted MBSR mHealth application prototype on anxiety symptoms, QOL, self-management, and glycemic control in 40 adolescents with T1D. Proposed career and learning objectives are to: 1. Develop comprehensive knowledge of mHealth intervention development and implementation.; 2. Acquire intensive training in the delivery of MBSR.; and 3. Disseminate findings through national and international presentations, and peer-reviewed publications. Long-term career goal: Build a robust program of externally-funded research to develop and disseminate interventions that are sustainable and actively utilized in clinical practice.

项目概要 1 型糖尿病 (T1D) 是美国青少年中最常见的慢性病之一， 影响大约四百分之一的 18 岁青少年。患有 T1D 的青少年面临急性发作的风险 以及长期并发症，包括糖尿病酮症酸中毒、严重低血糖以及心血管、肾脏、 和神经性疾病。保持足够的血糖控制可以降低这些并发症的风险。 焦虑症状在患有 T1D 的青少年中普遍存在，其发生率约为正常人的 2 至 3 倍。 一般青少年人口。焦虑症状与血糖控制超出范围、血糖控制不佳有关 生活质量（QOL）和自我管理能力差。减少焦虑症状的有针对性的干预措施将 有助于改善生活质量和改善 T1D 的自我管理，从而改善疾病结果。 尽管焦虑症状的患病率很高，并且与糖尿病相关并发症有很强的关联性， 针对这一高危人群采取的循证干预措施很少。该提案使用了 系统和迭代的方法，以适应针对焦虑症状、正念的循证干预措施 基于减压（MBSR），专门为了满足该人群的发展和生活方式需求。 我寻求指导研究职业发展奖的目标是获得知识、技能和 成为一名独立的临床研究者所需的研究经验，专注于开发、 实施和测试行为干预措施并改善患有类型的青少年的疾病结果 1 糖尿病（T1D）。该提案构建并测试了改编的 MBSR 的可行性和可接受性 针对 T1D 青少年的移动医疗应用程序。该混合方法提案的具体目标是： 1. 分析对 20 名 T1D 青少年的定性访谈，并对 10 个主要利益相关者进行访谈 （儿科内分泌科医生、儿科内分泌 (PE) 执业护士、体育护士、体育心理学家和体育 社会工作者）以确定与焦虑管理、正念相关的挑战、需求和看法 基于干预措施和移动医疗应用功能。 2. 生成一个移动医疗应用程序原型 整合从目标 1 获得的数据，专门针对患有 T1D 的青少年调整 MBSR； 3a.评估 MBSR 移动医疗应用原型，用于评估 40 名青少年的参与度、可行性和可接受性 T1D；和3b。探索改编后的 MBSR 移动医疗应用原型对焦虑的初步功效 40 名 T1D 青少年的症状、生活质量、自我管理和血糖控制。 建议的职业和学习目标是： 1. 发展移动医疗干预的全面知识 开发和实施。 2. 接受MBSR实施强化培训； 3. 传播 通过国家和国际演讲以及同行评审出版物得出的结论。 长期职业目标：建立一个强大的外部资助研究计划来开发和传播 可持续并在临床实践中积极利用的干预措施。