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

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

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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.

项目摘要/摘要糖尿病前是影响8800万美国成年人的重大公共卫生问题，并增加了患有5年风险高达50％的糖尿病。 NIDDK优先检查了行为方法预防2型糖尿病。该应用程序旨在通过开发糖尿病前数字来解决此优先级激活工具增加患者激活，这是健康结果的关键驱动力。患者激活鼓励授权患者知识渊博和激活，并在管理方面是合作伙伴他或她的健康。但是，在临床实践中，初级保健临床医生（PCP）通常没有时间或培训使用客观工具评估患者的激活，这可能会导致他们提出建议可能根本不会遵循或根本不提出任何建议。这种障碍可能导致低比率转诊和参与糖尿病预防计划（DPP），这是一年的生活方式计划降低了患糖尿病的风险。我们的总体目标是将预防糖尿病活动的患者百分比增加到减少糖尿病的事件。为了满足这一需求，我们提出以下相互关联的特定目的：1）开发糖尿病前期患者激活工具（DPAT），以评估患者的激活水平，为临床医生生成与糖尿病前期有关的访问目标，指导访问该目标的问题，以及支持将患者从较低激活阶段转移到更高阶段的资源列表，以及2）进行DPAT的试验组随机对照试验与通常的护理，以评估的主要结果患者激活增加，然后对参与者和PCP的一部分进行访谈 DPAT的可接受性和可行性。目标人群包括前糖尿病和BMI≥25kg/m2的成年人具有电子健康记录患者门户帐户的人。我们假设使用此工具的患者的激活水平会增加，报告更大满意度的水平和经验，最终，更有可能参加并参与DPP 给通常的护理小组的参与者。这项试验研究的数据将提供初步数据以测试该数字患者激活工具对较大随机的患者激活和DPP注册的有效性跨卫生系统的对照试验。