Developing a patient-centered psychoeducational tool to realize the potential of diabetes technologies

开发以患者为中心的心理教育工具，以实现糖尿病技术的潜力

• 批准号: 10686012
• 负责人: Brynn E Marks
• 金额: $ 18.22万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10686012
• 关键词: 12 year old; Acute; Address; Adult; Advisory Committees; Behavior; Behavior Therapy; Behavioral; Caring; Child; Child Care; Childhood; Chronic; Clinical; Continuous Glucose Monitor; Controlled Clinical Trials; Data; Development; Devices; Diabetes Mellitus; Education; Educational Curriculum; Educational Technology; Educational process of instructing; Endocrinology; Evaluation; Family; Future; Glycosylated hemoglobin A; Goals; Growth and Development function; Incidence; Individual; Instruction; Insulin Infusion Systems; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; K-Series Research Career Programs; Knowledge; Knowledge acquisition; Leadership; Learning; Learning Skill; Medical; Medical Education; Mentors; Mentorship; Methodology; Multicenter Studies; Needs Assessment; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Parents; Patients; Persons; Physicians; Problem Solving; Process; Provider; Qualitative Research; Quality of life; Randomized, Controlled Trials; Research; Research Personnel; Sampling; School-Age Population; Scientist; Semantics; Standardization; Techniques; Technology; Testing; Time; Training; Translating; Youth; acceptability and feasibility; assessment application; career development; clinical practice; design; diabetes educator; diabetes management; diabetes self-management; early adolescence; education research; eligible participant; experience; glycemic control; health related quality of life; improved; improved outcome; innovation; motivational enhancement therapy; novel; parental monitoring; patient oriented; preadolescence; prevent; psychoeducation; psychoeducational; psychoeducational intervention; recruit; research study; satisfaction; skills; tool; uptake

PROJECT SUMMARY / ABSTRACT Despite increased use of insulin pumps (IP) and continuous glucose monitors (CGM) for pediatric type 1 diabetes (T1D) management and research studies showing benefits from the use of these devices, real-world glycemic control among youth with T1D has worsened in recent years. The lack of improvement in glycemic control despite increased use of these technologies indicates that youth receiving routine clinical T1D care are not realizing the full potential of IP and CGM. Although greater youth and parental diabetes knowledge is associated with better glycemic control, education alone is not sufficient to bring about the behavioral changes needed to improve outcomes in T1D. Psychoeducation recognizes the need to blend educational and behavioral approaches, including problem-solving and goal-setting, to support parents in developing optimal T1D management approaches. There are currently a lack of effective standardized tools to support patients and families in developing the knowledge and behavioral strategies needed to optimize the use of diabetes technologies. The development of innovative family-centered psychoeducational tools addressing both behavior and knowledge will help to realize the full potential of diabetes technologies to improve glycemic control and quality of life while ultimately preventing or delaying the development of both acute and long-term complications of T1D. The scientific goal of this proposal is to identify the unmet psychoeducational needs of parents of children 8-12 years of age using IP and CGM for pediatric T1D management and to leverage that information to develop an innovative psychoeducational intervention to optimize use of these technologies and improve T1D outcomes. In Aim 1, semantic content analysis of interviews involving children with T1D, their parents, and diabetes clinicians will be used to identify unmet educational and behavioral needs of parents and children using these technologies. We previously developed an app-delivered T1D technology education curriculum for clinicians and in Aim 2 will use instructional design and stakeholder input to adapt the existing curriculum to meet the specific needs of parents of school age children with T1D. Finally, in Aim 3, we will pilot this psychoeducational intervention. Parents will complete 4 months of the app-delivered psychoeducational curriculum and dyads will also meet with a diabetes educator trained in motivational interviewing to reinforce knowledge and problem solving skills learned in the curriculum by applying them to personal IP and CGM data. With the support of my mentors and advisory committee comprised of experts in T1D behavioral interventions, medical and family-facing education, and qualitative research, I will attain the career development goals of learning advanced techniques in qualitative and quantitative research, developing expertise in family-facing psychoeducational interventions, and cultivating the leadership skills needed to translate my findings into clinical practice. This mentored career development award will support my development as an independent investigator capable of harnessing the unmet potential of diabetes technologies. Outcomes will be used to power a randomized controlled trial for a future R01 submission.

项目摘要 /摘要 尽管使用胰岛素泵（IP）和连续葡萄糖监测器（CGM）的使用增加了小儿1型糖尿病 （T1D）管理和研究表明使用这些设备的好处，现实世界中的血糖 近年来，T1D青年的控制恶化。尽管 这些技术的使用增加表明，接受常规临床T1D护理的青年没有意识到 IP和CGM的全部潜力。尽管更大的青年和父母糖尿病知识与更好 血糖控制，仅教育就不足以实现改善所需的行为变化 T1D的结果。心理教育认识到需要融合教育和行为方法的必要性， 包括解决问题和目标设定，以支持父母开发最佳T1D管理 方法。目前缺乏有效的标准化工具来支持患者和家庭 开发优化糖尿病技术使用所需的知识和行为策略。这 开发创新的以家庭为中心的心理教育工具来解决行为和知识 将有助于实现糖尿病技术的全部潜力，以改善血糖控制和生活质量 最终阻止或延迟T1D急性和长期并发症的发展。 该提议的科学目标是确定8-12岁儿童父母的未满足的心理教育需求 使用IP和CGM进行小儿T1D管理的年龄，并利用该信息开发创新的 心理教育干预以优化这些技术的使用并改善T1D结果。在AIM 1中， 涉及T1D儿童，父母和糖尿病临床医生的儿童的访谈语义内容分析将是 用于使用这些技术来确定父母和孩子的未满足的教育和行为需求。我们 以前为临床医生开发了一项应用程序的T1D技术教育课程，在AIM 2中将使用 教学设计和利益相关者的投入，以适应现有课程，以满足父母的特定需求 学龄儿童T1d。最后，在AIM 3中，我们将尝试这种心理教育干预。父母会 完成4个月的App授予心理教育课程和二元组也将与糖尿病相遇 受过培训的教育者进行了励志访谈，以增强知识和解决问题的技能 课程将其应用于个人IP和CGM数据。在我的导师和咨询的支持下 由T1D行为干预，医疗和面向家庭教育的专家组成的委员会 定性研究，我将实现学习定性技术高级技术的职业发展目标 定量研究，在面向家庭的心理教育干预方面发展专业知识，并培养 将我的发现转化为临床实践所需的领导技能。这个指导的职业发展奖 将支持我作为一个能够利用未满足潜力的独立调查员的发展 糖尿病技术。结果将用于为未来R01提交的随机对照试验提供动力。

项目成果

Applying the use of shared medical appointments (SMAs) to improve continuous glucose monitor (CGM) use, glycemic control, and quality of life in marginalized youth with type 1 diabetes: Study protocol for a pilot prospective cohort study.

• DOI: 10.1016/j.conctc.2023.101067
• 发表时间: 2023-04
• 期刊: Contemporary clinical trials communications
• 影响因子: 1.5

Case Report: Insulin hypersensitivity in youth with type 1 diabetes.

• DOI: 10.3389/fendo.2023.1226231
• 发表时间: 2023
• 期刊: Frontiers in endocrinology
• 影响因子: 5.2

Differences in positive expectancy of hybrid closed loop (HCL) insulin delivery systems do not explain racial differences in HCL use.

• DOI: 10.1016/j.jcte.2023.100319
• 发表时间: 2023-06
• 期刊: JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY
• 影响因子: 3
• 作者: Grundman, Jody B.;Perkins, Amanda;Monaghan, Maureen;Meighan, Seema;Streisand, Randi;Marks, Brynn E.
• 通讯作者: Marks, Brynn E.