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 (DSMES) 被认为是护理的基石和必需的 帮助人们进行自我管理决策和活动。尽管有证据表明 DSMES 是一个关键 作为糖尿病护理的一部分，参与度仍然很低。成年初期（EA）被描述为 18 至 25 岁之间的独特时期，青少年努力实现自主和探索生活 走向成年的可能性。自我管理欠佳已被确定为一个主要问题 在患有 1 型糖尿病 (T1D) 的 EA 中，这是一个特别脆弱的群体，患糖尿病相关疾病的风险增加 结果。目前形式的 DSMES 被认为无法满足 EA 的需求，而 EA 已 对通过同行支持、技术和应用学习驱动的方法提供的 DSMES 表示兴趣。 为了应对这些挑战，我们将从文献和主要利益相关者那里获得的信息应用于我们的 建立了远程医疗覆盖、教育、获取和治疗 (TREAT) 交付模式，并具有特定的 专注于DSMES。 TREAT-ED（自我管理教育）旨在专门让 EA 参与 DSMES 通过整合 DSMES 目标来支持知情决策、自我护理和准备 转移到成人护理，以改善结果。糖尿病护理和教育专家 (DCES) 将领导 TREAT- ED 与一群 EA 合作，将 1) 帮助组织和促进通过远程医疗提供的小组会议 2) 使用连续血糖监测 (CGM) 报告作为个性化示例来推动已建立的 DSMES 内容。通过以用户为中心的设计技术，我们将评估实施决定因素，然后 开发、构建和测试 TREAT-ED 模型。模型对 EA 患者影响的可行性评估 将审查 DSMES 的参与情况以及临床、心理和行为结果。我们 假设模型依赖于当前的策略来让 EA 参与糖尿病相关的高风险 有效自我管理技能的问题将提高 DSMES 的参与度和成果。如果证明是 有效，该模型可以适用于已转入成人糖尿病护理和其他护理的 EA 美国各地的患者群体。