ADAPTING AND ASSESSING THE FEASIBILITY OF A TELEHEALTH DIABETES PREVENTIONPROGRAM FOR HISPANIC ADOLESCENTS

调整和评估西班牙裔青少年远程健康糖尿病预防计划的可行性

基本信息

批准号：
10513488
负责人：
Erica Soltero
金额：
$ 15.08万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10513488
关键词：
Accelerometer Address Adolescent Adult Age Area Award Body Weight decreased Body mass index COVID-19 Cellular Phone Childhood Collaborations Communication Communities Cost of Illness Data Collection Development Devices Diabetes Mellitus Diabetes prevention Disease Disease Outcome Education Educational workshop Effectiveness Ensure Exhibits Family Feedback Focus Groups Foundations Funding Glycosylated hemoglobin A Goals Group Interviews Health behavior Health behavior outcomes Health education Healthcare Hispanic Home Insulin Insulin Resistance Insurance Coverage Internet Intervention Interview K-Series Research Career Programs Lead Life Expectancy Mentors Mentorship Methods Minority Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Outcome Parents Participant Persons Phase Physical activity Plant Roots Population Prediabetes syndrome Prevention Prevention program Prevention strategy Process Quality of life Randomized Reporting Research Research Personnel Sampling Schedule Science Scientist Self Determination Self Perception Services Survey Methodology Technology Testing Text Messaging Training Transportation Treatment Efficacy United States Centers for Medicare and Medicaid Services Work Youth acceptability and feasibility base behavior change community clinic design diabetes prevention program diabetes risk digital disorder prevention evidence base experience fasting glucose feasibility testing field study fitbit health care delivery health disparity high risk innovative technologies insulin sensitivity intervention delivery lifestyle intervention lifetime risk meetings minority children multidisciplinary novel nutrition nutrition education prevent preventive intervention programs recruit remote delivery skills social determinants social health determinants technology development telehealth telehealthcare theories tool treatment as usual usability usual care arm vulnerable community

项目摘要

Project Summary Hispanic adolescents are disproportionately burdened by type 2 diabetes (T2D) and social determinants of health (SDoH), which can serve as barriers to behavior change and participation in disease prevention efforts. Telehealth is a potentially effective approach for delivering disease prevention programs in vulnerable communities as it reduces the burden of some SDoH like transportation, childcare needs, and parent work schedules. However, there are no theory- or evidence-based telehealth T2D prevention programs for Hispanic youth. The goal of this career development award is to assist Dr. Erica Soltero in her long-term goal of becoming an independent investigator designing and implementing T2D prevention interventions among high-risk pediatric populations impacted by SDoH. Dr. Soltero’s short-term goals include gaining expertise in the use of mixed- methods, the Self-Determination Theory (SDT), and development of technology-based interventions. In collaboration with her multidisciplinary mentorship team, she has developed a training plan to reach these goals via coursework, workshops, scientific meetings, and mentored research. The purpose of this study is to adapt Everly Little Step Counts (ELSC), an evidence-based, culturally grounded T2D prevention program, for delivery via telehealth and test the feasibility and acceptability of the adapted telehealth intervention. While telehealth is more suited for remotely delivering nutrition education, other technology-based tools are needed to remotely promote physical activity (PA). Thus, we will adapt and integrate our previously tested intervention that uses activity trackers (i.e. Fitbit) and text-messages grounded in the SDT to promote PA into the telehealth program. To ensure that all technology-based components are feasible and considerate of SDoH, we will use a mixed- methods approach across three iterative phases to engage Hispanic adolescents (14-16 years; N=24) and their parents (N=24) in the adaptation process. Once the ELSC-telehealth program is developed, a new sample of Hispanic adolescents (14-16 years; N=40) with obesity (BMI%≥95th) will be recruited from community clinics and randomized to the 12-week ELSC-telehealth intervention or usual care control group. Feasibility and acceptability will be assessed using a priori feasibility criteria (e.g. recruitment, data collection, fidelity) and exit interviews. We will examine the preliminary efficacy of the intervention on PA and T2D risk outcomes (fasting glucose, insulin, insulin resistance and HbA1c). This proposal builds on the investigative team’s previous work in T2D prevention, activity trackers, and text messaging to develop a telehealth delivered T2D prevention program with great potential for reaching and engaging Hispanic youth. This study will advance the science on telehealth as a disease-prevention tool among high-risk youth impacted by SDoH. Completion of the proposed training and research will provide Dr. Soltero with the skills, research experience, professional development, and scholarly products needed to apply for R01 funding and transition to a successful, independent scientist.

项目概要西班牙裔青少年承受着 2 型糖尿病 (T2D) 和健康社会决定因素的不成比例的负担 (SDoH)，这可能成为行为改变和参与疾病预防工作的障碍。远程医疗是为弱势群体提供疾病预防计划的一种潜在有效方法社区，因为它减轻了某些 SDoH 的负担，例如交通、儿童保育需求和家长工作然而，目前还没有针对西班牙裔人的基于理论或证据的 T2D 预防计划。该职业发展奖的目标是帮助 Erica Soltero 博士实现成为一名青年人的长期目标。一位独立研究者在高危儿科中设计和实施 T2D 预防干预措施受 SDoH 影响的人群的短期目标包括获得使用混合技术的专业知识。方法、自决理论（SDT）以及基于技术的干预措施的发展。她与她的多学科指导团队合作，制定了一个培训计划来实现这些目标通过课程作业、研讨会、科学会议和指导研究，这项研究的目的是适应。 Everly Little Step Counts (ELSC)，一项基于证据、以文化为基础的 T2D 预防计划，用于交付通过远程医疗并测试改编后的远程医疗干预措施的可行性和可接受性。更适合远程提供营养教育，需要其他基于技术的工具来远程因此，我们将调整和整合我们之前测试过的干预措施。活动跟踪器（即 Fitbit）和基于 SDT 的短信，以促进 PA 进入远程医疗计划。为了确保所有基于技术的组件都是可能的并且考虑到SDoH，我们将使用混合- 方法跨越三个迭代阶段来吸引西班牙裔青少年（14-16 岁；N=24）及其一旦制定了 ELSC 远程医疗计划，就会产生一个新的样本（N=24）。将从社区诊所招募患有肥胖症（BMI%≥95）的西班牙裔青少年（14-16岁；N=40）并随机分配到为期 12 周的 ELSC 远程医疗干预组或常规护理对照组。将使用先验可行性标准（例如招聘、数据收集、保真度）和退出来评估可接受性我们将检查干预措施对 PA 和 T2D 风险结果（禁食）的初步效果。该提案建立在研究团队之前的工作基础上。 T2D 预防、活动跟踪器和短信，以开发远程医疗提供的 T2D 预防这项研究将推动西班牙裔青年的科学发展。远程医疗作为受 SDoH 影响的高危青少年的疾病预防工具完成拟议的工作。培训和研究将为 Soltero 博士提供技能、研究经验、专业发展和学术产品需要申请 R01 资助并转型为成功的独立科学家。