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) 的青少年依从性和血糖控制不佳的风险很高。青少年依从性的一些最普遍的障碍本质上是社会心理的，例如压力、耻辱、时间压力、社交场合以及与同龄人和父母的沟通。糖尿病研究和专业组织支持发展解决问题的技能，以解决青少年依从性的障碍。为了满足 T1D 青少年、家长和诊所的需求，我们创建了一种互联网依从性问题解决干预措施，名为 YourWay。初步结果表明，对依从性的影响中等，但对干预的参与程度存在差异。根据我们的初步研究，我们建议通过三个新的设计功能大幅推进我们的干预措施：1）使用生态瞬时评估（EMA）的移动数据收集系统，用行为依从性数据和多媒体内容填充干预措施，并提高对依从性障碍的认识， 2) 一个新的主页，将 EMA 数据、BG 值和青少年生成的多媒体内容集成到个人坚持故事中，以及 3) 与同龄人一起进行专注于解决坚持问题的社交学习活动。这些增强的功能将提供更客观、更具吸引力的数据，以指导和激励遵守问题的解决，并提供与同伴有关遵守的内在动机的社交互动。我们的目标包括 1) 建立有关青少年使用健康信息技术治疗糖尿病的当前行为和信念，特别是与同龄人分享个人健康信息相关的行为和信念，2) 针对每个功能进行重点迭代设计周期，以确定最具吸引力和最可接受的功能界面和依从性数据共享活动，以及 3) 一项试点随机试验，以评估干预措施对血糖控制 (A1C) 的影响。目前没有针对该人群的资源将与同龄人的社交互动与技能建设活动结合起来以提高依从性。拟议的互联网干预将创新地将这些功能组合成个人故事的形式。该干预措施非常有可能让青少年参与解决依从性问题、提高依从性并减少与血糖控制不良相关的严重医疗后果。 公共卫生相关性：患有 1 型糖尿病的青少年面临自我保健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种干预措施，通过教授解决问题的技能以及通过互联网和手机提供基于同伴的教育活动来支持青少年的自我保健。该研究将有助于我们了解青少年采用基于技术的糖尿病教育工具以及如何让青少年参与依从性教育。