Using Social Learning to Improve Adolescent Diabetes Adherence Problem Solving

利用社交学习提高青少年糖尿病依从性问题解决

• 批准号: 8437060
• 负责人: SHELAGH A MULVANEY
• 金额: $ 179.8万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-21 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8437060
• 关键词: Address; Adherence; Adolescent; Adolescent Behavior; Adoption; Attitude; Awareness; Behavior; Behavioral; Belief; Benefits and Risks; Blood Glucose; Car Phone; Clinic; Cognitive; Communication; Control Groups; Data; Data Collection; Development; Devices; Diabetes Mellitus; Dose; Education; Educational Activities; Educational Intervention; Educational process of instructing; Feedback; Goals; Health; Individual; Insulin-Dependent Diabetes Mellitus; Internet; Intervention; Kidney Diseases; Lead; Learning; Manufacturer Name; Medical; Methods; Modeling; Multimedia; Names; Nature; Parents; Participant; Patients; Pattern; Pilot Projects; Population; Prevalence; Problem Solving; Process; Professional Organizations; Randomized Controlled Trials; Recommendation; Research; Research Support; Resources; Retinal Diseases; Risk; Self Care; Social Interaction; Stigmata; Stress; System; Technology; Testing; Time; Translations; arm; base; data sharing; design; evidence base; experience; glycemic control; group intervention; health information technology; high risk; improved; innovative technologies; insight; iterative design; peer; pressure; psychosocial; randomized trial; skills; social; social stigma; social stress; tool

DESCRIPTION (provided by applicant): Adolescents with type 1 diabetes (T1D) are at high risk for poor adherence and glycemic control. Some of the most prevalent barriers to adherence in adolescents are psychosocial in nature, such as stress, stigma, time pressures, social situations, and communication with peers and parents. Diabetes research and professional organizations support the development of problem solving skills to resolve barriers to adolescent adherence. In order to address the needs of adolescents with T1D, parents, and clinics, we created an Internet adherence problem solving intervention, named YourWay. Initial results indicated moderate impact on adherence but variable engagement with the intervention. Based on our preliminary studies, we propose substantially advancing our intervention through three new design features: 1) a mobile data collection system using ecological momentary assessment (EMA) to populate the intervention with behavioral adherence data and multimedia content and improve awareness of adherence barriers, 2) a new homepage that integrates EMA data, BG values, and adolescent-generated multimedia content into personal adherence stories, and 3) social learning activities with peers focused on adherence problem solving. These enhanced features will provide more objective and more engaging data to guide and motivate adherence problem solving and provide intrinsically motivated social interactions with peers about adherence. Our aims include 1) establishing current behaviors and beliefs regarding adolescent use of health information technology for diabetes, and specifically those related to sharing personal health information with peers, 2) focused iterative design cycles for each of these features to identify the most engaging and acceptable interface and adherence data sharing activities, and 3) a pilot randomized trial to assess the impact of the intervention on glycemic control (A1C). There are currently no resources for this population that integrate social interactions with peers with skill building activities to improve adherence. The proposed Internet intervention will innovatively combine these features into a personal story format. The intervention has a high potential for engaging adolescents in adherence problem solving, improving adherence, and reducing the serious medical consequences related to poor glycemic control. PUBLIC HEALTH RELEVANCE: Adolescents with type 1 diabetes are at risk for inadequate self-care and glycemic control, which may lead to serious health consequences. The proposed research will design and test an intervention to support adolescent self-care through teaching problem solving skills and providing peer-based educational activities through the Internet and mobile phones. The research will contribute to our understanding of adolescent adoption of technology-based educational tools for diabetes and how to engage adolescents in adherence education.

描述（由申请人提供）：患有1型糖尿病（T1D）的青少年对依从性和血糖控制差的高风险。青少年遵守的一些最普遍的障碍本质上是社会心理的，例如压力，污名，时间压力，社交状况以及与同龄人和父母的沟通。糖尿病研究和专业组织支持开发解决问题的技能，以解决青少年遵守的障碍。为了满足T1D，父母和诊所的青少年需求，我们创建了一个互联网依从性解决干预措施，名为您。最初的结果表明对依从性的影响中等，但与干预措施的参与度变化。 Based on our preliminary studies, we propose substantially advancing our intervention through three new design features: 1) a mobile data collection system using ecological momentary assessment (EMA) to populate the intervention with behavioral adherence data and multimedia content and improve awareness of adherence barriers, 2) a new homepage that integrates EMA data, BG values, and adolescent-generated multimedia content into personal adherence stories, and 3) social learning activities同龄人专注于依从性问题解决。这些增强的功能将提供更客观，更吸引人的数据，以指导和激励依从性问题解决，并提供与同伴有关依从性的本质上动机的社交互动。 Our aims include 1) establishing current behaviors and beliefs regarding adolescent use of health information technology for diabetes, and specifically those related to sharing personal health information with peers, 2) focused iterative design cycles for each of these features to identify the most engaging and acceptable interface and adherence data sharing activities, and 3) a pilot randomized trial to assess the impact of the intervention on glycemic control (A1C).目前，该人群尚无资源，可以将与同行的社会互动与技能建设活动相结合以提高依从性。拟议的互联网干预将创新将这些功能结合到个人故事格式中。该干预措施具有使青少年参与依从性问题，改善依从性并减少与血糖控制不良有关的严重医疗后果的高潜力。 公共卫生相关性：患有1型糖尿病的青少年有自我护理和血糖控制不足的风险，这可能会导致严重的健康后果。拟议的研究将设计和测试一项干预措施，通过教学解决问题技能并通过互联网和手机提供基于同行的教育活动，以支持青少年的自我保健。这项研究将有助于我们理解青少年对糖尿病的基于技术的教育工具，以及如何使青少年参与依从性教育。