Enhancing Group Identify May Improve Effectiveness of Diabetes Self-Management Ed

增强群体认同可以提高糖尿病自我管理的有效性

• 批准号: 7911250
• 负责人: Janet Suttie
• 金额: $ 20.07万
• 依托单位: ADVANCED TELECARE, LLC
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7911250
• 关键词: Address; Adherence; Adoption; Adult; American; Area; Attitude; Blood Glucose; Businesses; County; Development; Diabetes Mellitus; Diabetic Angiopathies; Diet; Disease Management; Distant; Economic Burden; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Ensure; Evolution; Family; Feasibility Studies; Fostering; Glycosylated Hemoglobin; Goals; Group Affiliation; Guidelines; Habits; Health; Health behavior; Improve Access; Institutes; Knowledge; Lead; Learning; Life Style; Location; Metabolic Control; Motivation; Names; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Phase; Physicians; Pre-Post Tests; Primary Health Care; Public Health; Randomized; Randomized Clinical Trials; Recruitment Activity; Regimen; Research; Research Personnel; Self Care; Self Management; Site; Small Business Innovation Research Grant; Social Identification; Staging; Technology; Testing; Videoconferences; Videoconferencing; Work; base; behavior change; cardiovascular risk factor; clinical care; commercialization; cost; design; diabetes control; diabetes education; diabetes educator; diabetes management; experience; group competition; improved; innovation; innovative technologies; primary outcome; public health relevance; satisfaction; secondary outcome; sound; success; telecare; telehealth; theories; tool

DESCRIPTION (provided by applicant): The economic burden of diabetes on patients and their families is considerable. According to the most recent estimate in 2007, the yearly cost of diabetes was approximately $174 billion. Landmark studies have demonstrated that improved metabolic control of patients with diabetes reduces microvascular complications, and cardiovascular risk. Despite proven advances, adherence to American Diabetes Association (ADA) clinical care guidelines is suboptimal. Diabetes self-management educational (DSME) curricula conducted by certified diabetes educators (CDE) in single and group sessions have been shown to foster adherence to medication regimens, self-management of blood glucose, and promote lifestyle changes to improve diet and activity. However, CDE workforce shortages may be related to suboptimal adoption of clinical care guidelines. Telehealth strategies such as interactive videoconferencing may improve access to a CDE by facilitating distant learning by adults with diabetes. The next challenge is the development of an approach to extend the potential reach of DSME using interactive videoconferencing to address more people with diabetes throughout the US. The capacity of telehealth technology for innovative strategies may be important in terms of new ways of using interactive videoconferencing to enhance self-care. The goals of Advanced TeleCare, LLC in this Phase 1 SBIR proposal are to 1) explore the feasibility of simultaneously conducting remote DSME to two groups of participants separated geographically and 2) evaluate potential benefits of this approach in terms of diabetes-related outcomes. To accomplish this, we propose the following two aims: 1) Modify a remote DSME curriculum based on social identity theory to stimulate knowledge sharing and collaborative learning to reinforce participant motivation, behavior change, and commitment by fostering cohesive group identities, and 2) Conduct a feasibility study of adults with Type 2 diabetes recruited from two primary care practices in Greenville County, SC and Seattle, WA who receive a shortened three-month remote DSME curriculum. Recruitment of sites in coastal states across the US will be a demonstration of possible reach of this approach. The primary outcome of the feasibility study will be GHb in a pre-test: post-test design and secondary outcomes will be participant attitudes about group affiliation and satisfaction. To address the research aims, our investigative team spans expertise and experience in diabetes management and research as well as telehealth strategies in the setting of a physician's practice. Previous work by these investigators involving all aspects of diabetes self-care both in-person and via telehealth technologies, ensure that the proposed Phase 1 work will be accomplished. This sets the stage for Advanced TeleCare's SBIR Phase 2 effectiveness study of Diabetes TeleCare2 and the development of a sound commercialization plan. PUBLIC HEALTH RELEVANCE: This project is relevant to public health because of the focus on evaluating new ways to teach and motivate people with diabetes to improve their health habits. First, a feasibility study will show how well a diabetes education session is delivered to two small groups of adults when each group is at a different primary care practice. To accomplish this, sessions will be conducted remotely by telehealth or interactive videoconferencing. Second, we will evaluate if ways to foster group identity, such as naming each group receiving education or doing group competitions, increase health behaviors that result in better control of diabetes.

描述（申请人提供）：糖尿病给患者及其家庭带来的经济负担相当大。根据 2007 年的最新估计，每年因糖尿病造成的损失约为 1740 亿美元。具有里程碑意义的研究表明，改善糖尿病患者的代谢控制可减少微血管并发症和心血管风险。尽管已取得了一些进展，但对美国糖尿病协会 (ADA) 临床护理指南的遵守情况并不理想。由经过认证的糖尿病教育者 (CDE) 在单次和小组课程中开展的糖尿病自我管理教育 (DSME) 课程已被证明可以促进对药物治疗方案的遵守、血糖的自我管理，并促进生活方式的改变，以改善饮食和活动。然而，CDE 劳动力短缺可能与临床护理指南的采用不理想有关。交互式视频会议等远程医疗策略可以通过促进成人糖尿病患者的远程学习来改善获得 CDE 的机会。下一个挑战是开发一种方法，利用交互式视频会议扩大 DSME 的潜在影响范围，为全美更多糖尿病患者提供服务。远程医疗技术对于创新策略的能力可能对于使用交互式视频会议来增强自我护理的新方法很重要。 Advanced TeleCare, LLC 在第一阶段 SBIR 提案中的目标是：1) 探索对地理上分开的两组参与者同时进行远程 DSME 的可行性；2) 评估这种方法在糖尿病相关结果方面的潜在益处。为了实现这一目标，我们提出以下两个目标：1）修改基于社会认同理论的远程 DSME 课程，以刺激知识共享和协作学习，通过培养有凝聚力的群体认同来加强参与者的动机、行为改变和承诺，以及 2）进行这是一项针对从南卡罗来纳州格林维尔县和华盛顿州西雅图两个初级保健机构招募的 2 型糖尿病成人患者进行的可行性研究，他们接受了为期三个月的远程 DSME 课程。在美国沿海各州招募站点将证明这种方法的可能影响范围。可行性研究的主要结果将是预测试中的 GHb：后测试设计和次要结果将是参与者对群体归属感和满意度的态度。为了实现研究目标，我们的研究团队涵盖了糖尿病管理和研究以及医生实践中的远程医疗策略方面的专业知识和经验。这些研究人员之前的工作涉及糖尿病自我护理的各个方面，无论是亲自还是通过远程医疗技术，确保了拟议的第一阶段工作的完成。这为 Advanced TeleCare 的糖尿病 TeleCare2 SBIR 第 2 阶段有效性研究和制定完善的商业化计划奠定了基础。 公共卫生相关性：该项目与公共卫生相关，因为重点是评估教导和激励糖尿病患者改善健康习惯的新方法。首先，可行性研究将显示当每组处于不同的初级保健实践时，向两小组成人提供糖尿病教育课程的效果如何。为了实现这一目标，会议将通过远程医疗或交互式视频会议远程进行。其次，我们将评估培养群体认同感的方法（例如为每个接受教育的群体命名或进行群体竞赛）是否可以增加健康行为，从而更好地控制糖尿病。