DiaBetter Together: A Strengths-Based Peer Mentor Program to Support Young Adults with Type 1 Diabetes During the Transition from Pediatrics to Adult Care

DiaBetter Together：一项基于优势的同伴导师计划，旨在支持患有 1 型糖尿病的年轻人从儿科到成人护理的过渡

• 批准号: 10646266
• 负责人: Marisa Ellen Hilliard
• 金额: $ 44.63万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10646266
• 关键词: Accountability; Adherence; Adolescence; Adult; Age; Age Years; Appointment; Behavioral; Biological Markers; Caring; Childhood; Clinic; Clinical; Communication; Dangerousness; Data; Development; Diabetes Mellitus; Distress; Education; Educational process of instructing; Evidence based program; Family; Family Relationship; Feeling; Friends; Glycosylated hemoglobin A; Goals; Health; Healthcare; Healthcare Systems; Hospitalization; Infrastructure; Insulin-Dependent Diabetes Mellitus; Interpersonal Relations; Intervention; Mediating; Mediation; Mediator; Methods; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Occupational; Outcome; Parents; Participant; Patient-Focused Outcomes; Patients; Pediatric Hospitals; Pediatrics; Personal Satisfaction; Persons; Problem Solving; Program Efficiency; Provider; Psychological reinforcement; Quality of life; Questionnaires; Randomized; Readiness; Recommendation; Regimen; Reporting; Research; Resources; Risk; Role; Schools; Self Care; Self Management; Social Workers; Social support; Source; Support System; Techniques; Testing; Texas; Time; Time Management; Training; Uncertainty; Visit; Work; arm; care providers; college; depressive symptoms; diabetes distress; diabetes management; diabetes self-management; emerging adult; experience; follow-up; glycemic control; group intervention; health care settings; high risk; improved; intervention participants; medical appointment; novel; novel strategies; peer; peer coaching; peer support; poor health outcome; prevent; primary outcome; programs; psychoeducation; psychoeducational; psychosocial wellbeing; resilience; role model; secondary outcome; skills; skills training; social; social cognitive theory; social model; social situation; stress management; treatment adherence; treatment as usual; young adult

PROJECT SUMMARY/ABSTRACT Type 1 diabetes (T1D) management is challenging for young adults, who assume responsibility for self- management and transfer T1D care from the pediatric to adult healthcare system as they also manage typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended (>6 months) gaps before following up in adult care, which increase their risk for poor health outcomes and serious health complications. There are few evidence-based programs to support young adults with T1D during the transfer period between pediatric and adult care. Novel, developmentally appropriate approaches are needed to help young adults negotiate the challenges of living with T1D and complete a timely transition to adult care. The goal of the proposed study is to evaluate a new intervention for young adults with T1D that maximizes diabetes-related social support. The proposed transition intervention builds on young adults' social support network and provides them access to relevant information about T1D care in adulthood. Around the time they leave pediatric T1D care, young adults with T1D will be paired with a trained “Peer Mentor,” an experienced, slightly older young adult with T1D, who will meet with them in-person and have frequent (weekly, then monthly) contact for 12 months. During the contacts, the Peer Mentor will use strengths-based psychoeducational strategies to teach and model problem-solving and stress-management skills, encourage the young adult to seek support from their existing social support network (e.g., family, friends) and identify new sources of diabetes-related support, help the young adult prioritize T1D self-care during the very demanding young adult period, share his/her transition experiences and strategies for successfully navigating the adult healthcare system, and prepare for the first adult care visit. The Peer Mentor will be a positive role model and source of help, encouragement, and accountability around transition, with the goal of reducing isolation, promoting self-management, and preventing gaps in care. We will test this intervention with 150 young adults randomly assigned to the intervention or usual care. Our main goal is to evaluate the intervention's impact on important T1D outcomes, such as glycemic control, time to adult care, treatment adherence, and psychosocial well-being. Clinic appointment information, questionnaires, adherence data, and glycemic control biomarkers will be collected at baseline and 6 and 12 months later. The ultimate goal of this research is to validate a supportive intervention that can facilitate T1D self-management and transfer of care during the difficult young adult years and promote optimal T1D health outcomes.

项目概要/摘要 1 型糖尿病 (T1D) 的管理对于年轻人来说具有挑战性，因为他们要承担自我管理的责任。 管理并将 T1D 护理从儿科医疗保健系统转移到成人医疗保健系统，因为他们还管理典型的 许多年轻人已经延长了发展需求（例如社交、财务、工作/学校、居住）。 （> 6 个月）在成人护理随访之前存在差距，这增加了他们健康状况不佳的风险， 很少有循证计划可以为患有 T1D 的年轻人提供支持。 儿科和成人护理之间的过渡期是新颖的、适合发育的方法。 需要帮助年轻人应对 1 型糖尿病生活的挑战并及时过渡到 拟议研究的目标是评估针对年轻 T1D 患者的新干预措施。 所提出的过渡干预措施以年轻人的社会支持为基础，最大限度地提高与糖尿病相关的社会支持。 支持网络，并为他们提供有关成年期 T1D 护理的相关信息。 当他们离开儿科 T1D 护理时，患有 T1D 的年轻人将与经过培训的“同伴导师”配对， 经验丰富、年龄稍大的患有 T1D 的年轻成人，他们将亲自与他们会面，并经常（每周、 然后每月）接触 12 个月 在接触期间，同伴导师将使用基于优势的方法。 教授和示范解决问题和压力管理技能的心理教育策略，鼓励 年轻人从现有的社会支持网络（例如家人、朋友）寻求支持并确定 糖尿病相关支持的新来源，帮助年轻人在最重要的时期优先考虑 T1D 自我护理 要求很高的年轻成人期，分享他/她的过渡经验和成功驾驭的策略 成人医疗保健系统，并为第一次成人护理访问做好准备 同伴导师将发挥积极作用。 围绕转型的帮助、鼓励和问责的模式和来源，目标是减少 隔离、促进自我管理以及防止护理差距 我们将在 150 名患者中测试这一干预措施。 我们的主要目标是评估被分配接受干预或常规护理的年轻人。 干预对重要 T1D 结局的影响，例如血糖控制、成人护理时间、治疗 依从性和社会心理健康状况。 血糖控制生物标志物将在基线以及 6 个月和 12 个月后收集。 研究旨在验证一种支持性干预措施，可以促进 T1D 自我管理和护理转移 度过困难的青年时期，并以最佳方式促进 T1D 健康结果。