Application of the Telemedicine for Reach, Education, Access, and Treatment delivery model to engage emerging adults in Diabetes Self-Management Education and Support (TREAT-ED)

应用远程医疗覆盖、教育、获取和治疗提供模式，让新兴成年人参与糖尿病自我管理教育和支持 (TREAT-ED)

• 批准号: 10651947
• 负责人: INGRID M LIBMAN
• 金额: $ 25.32万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-11 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10651947
• 关键词: Address; Adolescent; Adult; Affect; Behavior; Behavioral; Blood Glucose; COVID-19 pandemic; Caring; Clinic; Clinical; Continuous Glucose Monitor; Control Groups; Data; Decision Making; Development; Devices; Diabetes Mellitus; Education; Effectiveness; Ensure; Exhibits; Feasibility Studies; Future; Goals; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; Lead; Life; Literature; Methods; Modeling; Monitor; Outcome; Parents; Patient Monitoring; Patient Participation; Patients; Persons; Preparation; Problem Solving; Provider; Reporting; Research; Risk; Self Care; Self Management; Series; Services; Specialist; Techniques; Technology; Telemedicine; Testing; Time; Visit; Vulnerable Populations; Work; Youth; age group; behavioral outcome; clinical practice; cohort; collaborative approach; contextual factors; coping; design; design,build,test; diabetes risk; diabetes self-management; effectiveness measure; effectiveness/implementation study; emerging adult; emerging adulthood; experience; glucose monitor; hands-on learning; high risk; implementation determinants; implementation evaluation; implementation outcomes; implementation strategy; improved; improved outcome; interest; novel; novel strategies; patient population; peer support; pilot test; pilot trial; pragmatic trial; primary outcome; programs; prototype; psychosocial; response; satisfaction; skills; telehealth; therapy design; uptake; user centered design

Abstract Diabetes self-management education and support (DSMES) is considered a cornerstone of care and essential in helping people navigate self-management decisions and activities. Despite evidence that DSMES is a critical component of diabetes care, participation remains low. Emerging adulthood (EA) has been described as the distinct period between 18 and 25 years when adolescents work to achieve autonomy and explore life possibilities in moving toward adulthood. Suboptimal self-management has been identified as a major problem in EAs with type 1 diabetes (T1D), a particularly vulnerable group with an increased risk for poor diabetes-related outcomes. In its current form DSMES has been cited for not meeting the needs of EAs, when EAs have expressed interest in DSMES delivered with peer-supported, technological and applied learning-driven methods. To address these challenges, we are applying information gained from the literature and key stakeholders to our established Telemedicine for Reach, Education, Access and Treatment (TREAT) delivery model with a specific focus on DSMES. TREAT-ED (for self-management EDucation) will be designed to specifically engage EAs in DSMES by integrating DSMES objectives to support informed decision making, self-care, and preparation for transfer to adult care, to improve outcomes. Diabetes care and education specialists (DCESs) will lead TREAT- ED with a cohort of EAs and will 1) help to organize and facilitate group sessions delivered through telehealth and 2) use continuous blood glucose monitoring (CGM) reports as personalized examples to drive established DSMES content. With user-centered design techniques, we will evaluate implementation determinants and then develop, build, and test the TREAT-ED model. Feasibility assessment of the impact of the model on EA patient participation in DSMES along with clinical, psychosocial and behavioral outcomes will be examined. We hypothesize that models that rely on current day strategies to engage EAs at high risk for diabetes-related problems with effective self-management skills will improve DSMES engagement and outcomes. If proven to be effective, this model is one that could be adapted for EAs who have transferred to adult diabetes care and other patient populations throughout the US.

抽象的 糖尿病自我管理教育和支持（DSME）被认为是护理和重要的基石 帮助人们制定自我管理决策和活动。尽管有证据表明DSMES是关键 糖尿病护理的组成部分，参与仍然很低。新兴成年（EA）被描述为 在18至25年之间，青少年努力实现自主权并探索生活的不同时期 走向成年的可能性。次优的自我管理已被确定为一个主要问题 在1型糖尿病（T1D）的EA中，这是一个特别脆弱的群体，与糖尿病相关的风险增加增加 结果。以目前的形式，DSME被引用是因为不满足EAS的需求，而EAS 对使用同伴支持，技术和应用学习驱动的方法传递的DSME表示兴趣。 为了应对这些挑战，我们正在将文献和关键利益相关者收获的信息应用于我们的 建立的远程医疗，用于覆盖，教育，访问和治疗（治疗）交付模型 专注于DSME。待遇（用于自我管理教育）将旨在专门参与EAS DSME通过整合DSME的目标来支持知情的决策，自我保健和准备 转移到成人护理，以改善结果。糖尿病护理和教育专家（DCESS）将领导治疗 - 与EAS的同伙一起ed 1）帮助组织和促进通过Telehealth提供的团体会议 2）使用连续的血糖监测（CGM）报告作为个性化示例来驱动已建立的 DSMES内容。使用以用户为中心的设计技术，我们将评估实施确定因素，然后评估 开发，构建和测试治疗模型。对模型对EA患者的影响的可行性评估 将检查参与DSMES以及临床，社会心理和行为成果的参与。我们 假设依靠当前策略的模型使EAS与与糖尿病有关的高风险与EA 有效的自我管理能力的问题将改善DSMES的参与和结果。如果被证明是 有效的是，该模型可以适用于已转移到成人糖尿病护理和其他其他的EA的模型 整个美国的患者人口。