Adolescent Self-Management of Diabetes: An Intervention

青少年糖尿病的自我管理：干预措施

• 批准号: 7244034
• 负责人: SHELAGH A MULVANEY
• 金额: $ 18.63万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7244034
• 关键词: Address; Adherence; Adolescence; Adolescent; Behavior; Blood Glucose; Chronic Disease; Clinic; Clinical; Clinical Trials; Communication; Data; Development; Diabetes Mellitus; Education; Educational process of instructing; Ethnic Origin; Family; Food; Funding; Gender; Glycosylated hemoglobin A; Goals; Grant; Guidelines; Individual; Insulin-Dependent Diabetes Mellitus; Internet; Intervention; Knowledge; Learning; Link; Measurement; Medical; Metabolic Control; Methodology; Methods; Modality; Motivation; Outcome; Patients; Population; Problem Solving; Purpose; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recommendation; Research; Resources; Sampling; Self Management; Subgroup; Testing; Translating; Treatment Efficacy; United States National Institutes of Health; base; behavior change; clinical efficacy; computerized; cost; design; digital; digital models; glucose monitor; improved; interest; skills; theories; therapy design; therapy development

DESCRIPTION (provided by applicant): Adherence to treatment guidelines has been associated with improved long term clinical outcomes in adolescent diabetes. Despite the development of several probably efficacious interventions designed to improve self-management they have not been widely disseminated because of issues in feasibility. In order to address limitations of the traditional implementation of interventions, an internet-based problem solving intervention for adolescents with Type 1 diabetes is proposed. Aims include development of an intervention that may be administered through a website, determining feasibility, and conducting a small randomized trial of the intervention. The present approach to behavior change acknowledges that self-management is not viewed as the primary goal of the adolescent. Instead, the intervention seeks to link self-management to an individual's goals. Problem solving skills will be taught using multiple challenge-based learning cycles that each focus on a different barrier to self-management faced by adolescents. While teaching skills that have been reliably related to improved self-management, the intervention is considered exploratory as it translates an applied model and digital learning template from education for a chronic illness population and incorporates developmentally appropriate motivational theory. Patients will have access to a diabetes professional by posting questions to the website. Most clinical interactions involve didactic communication of what adolescents need to do, this intervention will help young patients determine why and how to implement what is recommended by their diabetes professional. If successful, the intervention will increase knowledge, problem solving skills, self-management behaviors, and ultimately clinical outcomes, using a cost-effective and sustainable methodology. Data from this research will be used to obtain further funding to test the intervention with a larger sample. A larger study will allow for reliable estimates of efficacy for clinical outcomes such as HbA1c, and will allow subgroup analyses with ethnicity, gender, and SES.

描述（由申请人提供）：遵守治疗指南与改善青少年糖尿病的长期临床结果相关。尽管开发了几种可能有效的旨在改善自我管理的干预措施，但由于可行性问题，它们尚未广泛传播。为了解决传统干预措施实施的局限性，提出了一种针对 1 型糖尿病青少年的基于互联网的问题解决干预措施。目标包括开发可通过网站实施的干预措施、确定可行性以及对该干预措施进行小型随机试验。目前的行为改变方法承认自我管理并不被视为青少年的首要目标。相反，干预措施旨在将自我管理与个人目标联系起来。将通过多个基于挑战的学习周期来教授解决问题的技能，每个学习周期都侧重于青少年面临的不同自我管理障碍。虽然教学技能与改善自我管理可靠相关，但该干预措施被认为是探索性的，因为它转化了慢性病人群教育中的应用模型和数字学习模板，并纳入了适合发展的动机理论。患者可以通过在网站上发布问题来联系糖尿病专家。大多数临床互动涉及青少年需要做什么的说教交流，这种干预将帮助年轻患者确定为什么以及如何实施糖尿病专业人士的建议。如果成功，干预将使用具有成本效益和可持续的方法来增加知识、解决问题的技能、自我管理行为以及最终的临床结果。这项研究的数据将用于获得进一步的资金，以更大的样本测试干预措施。更大规模的研究将能够对 HbA1c 等临床结果的疗效进行可靠估计，并允许进行种族、性别和 SES 的亚组分析。

项目成果

Self-management problem solving for adolescents with type 1 diabetes: intervention processes associated with an Internet program.

1 型糖尿病青少年的自我管理问题解决：与互联网程序相关的干预过程。

• DOI: 10.1016/j.pec.2010.09.018
• 发表时间: 2011
• 期刊: Patient education and counseling
• 影响因子: 3.5
• 作者: Mulvaney,ShelaghA;Rothman,RussellL;Osborn,ChandraY;Lybarger,Cindy;Dietrich,MaryS;Wallston,KennethA
• 通讯作者: Wallston,KennethA