Strengths-Based Multi-Level Behavioral Intervention to Promote Resilience and Self-Management in Youth with Type 1 Diabetes

基于优势的多层次行为干预可促进 1 型糖尿病青少年的复原力和自我管理

基本信息

批准号：
10522297
负责人：
Marisa Ellen Hilliard
金额：
$ 78.05万
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：
2022-07-20 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10522297
关键词：
Adherence Adolescence Adolescent Age Appointment Behavior Behavior Therapy Behavioral Caring Child Childhood Childhood diabetes Chronic Clinic Clinical Clinical Data Communication Conflict (Psychology)Data Deterioration Development Diabetes Mellitus Dose Early Intervention Electronic Health Record Family Future Glucose Glycosylated hemoglobin A Goals Health Health Technology Health behavior Health behavior change Healthcare Healthcare Systems Individual Insulin-Dependent Diabetes Mellitus Intervention Lead Linguistics Mediating Mediator of activation protein Medical Methods Modeling Outcome Parents Participant Patient Outcomes Assessments Pattern Persons Physiological Pilot Projects Prevention Preventive Provider Quality of life Randomized Reporting Research Risk Science Self Management Social support Structure System Targeted Research Testing Time Training Visit Washington Youth arm base behavioral adherence brief intervention care providers diabetes distress diabetes management diabetes self-management digital health education resources expectation experience follow-up glycemic control health related quality of life high risk improved innovation intervention effect medical appointment meetings mobile application multi-component intervention novel peer post intervention prevent preventive intervention primary outcome provider intervention psychosocial psychosocial wellbeing racial and ethnic recruit resilience satisfaction secondary outcome social social cognitive theory socioeconomics theories tool treatment arm treatment as usual

项目摘要

PROJECT SUMMARY/ABSTRACT Type 1 diabetes (T1D) management is particularly challenging during the transition to adolescence, as this developmental period is often marked by increasing expectations for independence in self-management and poorer glycemic and quality of life outcomes. In behavioral T1D research (largely conducted with adolescents), there has been limited evidence of meaningful, lasting impact on adherence behaviors or glycemic outcomes. Novel, developmentally appropriate approaches are needed to help youth achieve “diabetes resilience” – i.e., engage in high levels of self-management behaviors, achieve HbA1c levels within the target range, and experience good quality of life – during the important late childhood and early adolescent years. Prevention science and social-ecological theories of health behavior change for pediatric health conditions recognize the importance of early interventions that target multiple systems surrounding a child with a chronic condition like T1D to promote trajectories of positive behavioral, psychosocial, and medical outcomes. The goal of this study is to evaluate a new intervention for youth age 8-12 with T1D and elevated HbA1c that uses strengths-based methods to prevent the deterioration in outcomes often observed in adolescence. In this 6-month, multi-modal intervention: (1) diabetes care providers will use youth- and parent-reports of youth’s diabetes strengths and self-management behaviors to lead a discussion of what youth are doing well for T1D during a routine diabetes care appointment, (2) parents will use an app to recognize, track, and reinforce their children’s positive T1D- related behaviors and will have “3 minute meetings” with their child about a T1D self-management goal, and (3) youth will use an app to have positive interactions with parents about their diabetes strengths and build supportive social connections with peers through videos about living well with T1D. The intervention strategies are brief, low-burden, and use digital health technologies to deliver the intervention in the context of real-world diabetes activities (i.e., routine medical appointments and everyday T1D management). We will test this intervention with 250 racially/ethnically, socioeconomically, and linguistically diverse youth in Houston, TX and Washington, DC, who are randomly assigned to the intervention or enhanced usual care. Our goal is to evaluate the intervention’s impact on key T1D outcomes: HbA1c, % glucose time in range, engagement in T1D self- management behaviors, and health-related quality of life. We will also examine psychosocial and intervention- specific factors that may be mechanisms of the intervention’s effect. Data will be collected for 15 months. The ultimate goal of this research is to test the effects of a multi-level, strengths-based preventive intervention on health behaviors, psychosocial well-being, and T1D health outcomes during the critically important and understudied developmental stage of the transition to adolescence. Results will inform future intervention strategies to maximize resilient outcomes for youth with T1D who are at elevated risk for poor outcomes.

项目摘要/摘要在过渡到青少年期间，1型糖尿病（T1D）管理尤其具有挑战性发展时期通常以对自我管理中独立性的期望日益提高和血糖和生活质量较差。在行为T1D研究中（主要与青少年一起进行）有限的证据表明对依从性行为或血糖结果的有意义，持久影响。需要采用新颖的，开发的适当方法来帮助您实现“糖尿病的弹性” - 即参与高水平的自我管理行为，在目标范围内实现HBA1C水平，以及体验良好的生活质量 - 在童年和青少年早期的重要时期。预防科学和社会生态生物学的健康行为改变儿科健康状况的改变早期干预措施的重要性，该干预措施针对围绕儿童具有慢性病的多个系统 T1D促进积极行为，社会心理和医学结果的轨迹。这项研究的目标是用T1D和升高的HBA1C评估8-12岁的年轻人的新干预措施，该干预使用基于优势防止在青少年经常观察到的结果中定义的方法。在这个六个月的多模式中干预：（1）糖尿病护理提供者将使用青年和父母报告的青年糖尿病优势和自我管理行为，以讨论年轻人在常规糖尿病期间对T1D的表现很好护理约会，（2）父母将使用一个应用程序来识别，跟踪和加强孩子的正面T1D- 相关的行为，将与孩子举行“ 3分钟会议”，以实现T1D自我管理目标，（3）青年将使用应用程序与父母就糖尿病的长处进行积极互动并建立通过与T1D一起生活的视频，与同行的社交联系。干预策略短暂，低负担，并使用数字健康技术在现实世界中进行干预糖尿病活动（即常规医疗预约和每天的T1D管理）。我们将测试这个在德克萨斯州休斯敦和华盛顿特区，被随机分配到干预或增强通常的护理中。我们的目标是评估干预对关键T1D结果的影响：HBA1C，范围内的葡萄糖时间％，参与T1D自我管理行为和与健康相关的生活质量。我们还将检查社会心理和干预 - 可能是干预作用机制的特定因素。数据将收集15个月。这这项研究的最终目标是测试基于优势的预防性干预对至关重要的健康行为，社会心理健康和T1D健康成果过渡到青少年的发展阶段。结果将告知将来的干预为T1D年轻人最大化的弹性结局的策略，其预期风险较差。