Design and Pilot Test of A Prediabetes Digital Patient Activation Tool

糖尿病前期数字患者激活工具的设计和试点测试

基本信息

批准号：
10648646
负责人：
Eva Tseng
金额：
$ 12.28万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10648646
关键词：
Address Adopted Adult Affect Algorithms Applications Grants Assessment tool Behavior Behavioral Blood Pressure Body Weight decreased Body mass index Caring Case Manager Clinic Clinical Clinical Pathways Data Decision Aid Diabetes Mellitus Diabetes prevention Discipline Electronic Health Record Elements Eligibility Determination Enrollment Funding Goals Health Health system Incidence Individual Interview Investments Knowledge Lead Life Style Measures Methods Motivation National Institute of Diabetes and Digestive and Kidney Diseases Non-Insulin-Dependent Diabetes Mellitus Nurses Nutritionist Outcome Outcome Measure Participant Patient Education Patient Outcomes Assessments Patient Preferences Patient Self-Report Patients Persons Physical activity Pilot Projects Play Prediabetes syndrome Primary Care Physician Public Health Questionnaires Randomized, Controlled Trials Readiness Recommendation Reporting Research Resources Risk Risk Reduction Role Self Efficacy Self Management Target Populations Time Training Visit Weight Weight Gain Work acceptability and feasibility clinical practice design diabetes prevention program diabetes risk digital effective therapy effectiveness testing empowerment evidence base experience health service use high risk improved lifestyle intervention patient engagement patient health information patient portal patient-level barriers pilot test prevent primary care clinic primary care clinician primary outcome programs progression risk psychosocial stressors response satisfaction shared decision making tool treatment as usual uptake

项目摘要

PROJECT SUMMARY/ABSTRACT Prediabetes is a significant public health problem affecting 88 million U.S. adults and increases the risk of developing diabetes with a 5-year risk of up to 50%. The NIDDK has prioritized examining behavioral approaches to preventing type 2 diabetes. This application seeks to address this priority by developing a prediabetes digital activation tool to increase patient activation, which is a key driver of positive health outcomes. Patient activation encourages empowering patients to be knowledgeable and activated, and a collaborative partner in managing his or her health. However, in clinical practice, primary care clinicians (PCP) often do not have the time or training to use objective tools to assess their patient’s activation, which may lead them to making recommendations that may not get followed or not making any recommendations at all. This barrier likely contributes to the low rates of referral and participation in the Diabetes Prevention Program (DPP), a yearlong lifestyle program shown to decrease one’s risk of developing diabetes. Our overarching goal is to increase the percentage of patients engaging in diabetes prevention activities to reduce the incidence of diabetes. To address this need, we propose the following interrelated Specific Aims: 1) To develop a prediabetes digital patient activation tool (DPAT) that evaluates a patient’s activation level, generates for the clinician a visit goal related to prediabetes, questions to guide the visit toward that goal, and a list of resources that support moving the patient from a lower to higher stage of activation, and 2) To conduct a conduct a pilot group-randomized controlled trial of DPAT vs. usual care to assess the primary outcome of increased patient activation, followed by interviews of a subset of participants and PCPs to evaluate acceptability and feasibility of DPAT. The target population includes adults with prediabetes and BMI ≥25kg/m2 who have an electronic health record patient portal account. We hypothesize that patients who use this tool will have an increase in activation levels, report greater satisfaction level and experience, and ultimately, be more likely to be enroll and participate in the DPP compared to participants in the usual care group. Data from this pilot study would provide preliminary data to test the effectiveness of this digital patient activation tool on patient activation and DPP enrollment in a larger randomized controlled trial across a health system.

项目概要/摘要糖尿病前期是一个严重的公共卫生问题，影响着 8800 万美国成年人，并增加了患糖尿病的风险 NIDDK 优先考虑对行为方法进行检查，五年内患糖尿病的风险高达 50%。该应用程序旨在通过开发糖尿病前期数字化解决方案来解决这一问题。激活工具，以增加患者的激活，这是患者积极健康结果的关键驱动因素。鼓励赋予患者知识和活力，并成为管理方面的合作伙伴然而，在临床实践中，初级保健依从者 (PCP) 往往没有时间或没有培训。使用客观工具来评估患者的激活，这可能会导致他们提出建议可能不会被遵循或根本不提出任何建议，这一障碍可能导致了低比率。转诊和参与糖尿病预防计划 (DPP)，这是一项为期一年的生活方式计划，表明可以降低患糖尿病的风险。我们的总体目标是提高参与糖尿病预防活动的患者比例为了满足这一需求，我们提出以下相互关联的具体目标：1) 开发用于评估患者激活水平的糖尿病前期数字患者激活工具 (DPAT)，为临床医生生成与糖尿病前期相关的就诊目标、指导就诊实现该目标的问题，以及支持将患者从较低的激活阶段转移到较高的激活阶段的资源列表，以及 2) 进行 a 对 DPAT 与常规护理进行试点组随机对照试验，以评估主要结局增加患者的积极性，然后对一部分参与者和 PCP 进行访谈以进行评估 DPAT 的可接受性和可行性目标人群包括糖尿病前期且 BMI ≥25kg/m2 的成年人。拥有电子健康记录患者门户帐户的人。我们发现使用该工具的患者的激活水平会增加，报告更大与 DPP 相比，满意度水平和经验，最终更有可能注册和参与 DPP 来自该试点研究的数据将为测试该试验提供初步数据。该数字患者激活工具在更大的随机试验中对患者激活和 DPP 登记的有效性整个卫生系统的对照试验。