DiaBetter Together: A Strengths-Based Peer Mentor Program to Support Young Adults with Type 1 Diabetes During the Transition from Pediatrics to Adult Care

DiaBetter Together：一项基于优势的同伴导师计划，旨在支持患有 1 型糖尿病的年轻人从儿科到成人护理的过渡

• 批准号: 10215495
• 负责人: Marisa Ellen Hilliard
• 金额: $ 49.33万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10215495
• 关键词: Accountability; Adherence; Adolescence; Adult; Age; Age-Years; Appointment; Behavioral; Biological Markers; Caring; Childhood; Clinic; Clinical; Cognitive; Dangerousness; Data; Development; Diabetes Mellitus; Distress; Evidence based program; Family; Family Relationship; Feeling; Friends; Glycosylated hemoglobin A; Goals; Health; Healthcare; Healthcare Systems; Hospitalization; Infrastructure; Insulin-Dependent Diabetes Mellitus; Interpersonal Relations; Intervention; Logistics; Mediating; Mediation; Methods; Modeling; Occupational; Outcome; Parents; Participant; Patient-Focused Outcomes; Patients; Pediatric Hospitals; Pediatrics; Personal Satisfaction; Persons; Problem Solving; Provider; Psychological reinforcement; Quality of life; Questionnaires; Randomized; Readiness; Recommendation; Regimen; Reporting; Research; Resources; Risk; Role; Schools; Self Care; Self Management; Social Workers; Social support; Source; Supervision; Support System; Techniques; Testing; Texas; Time; Time Management; Training; Uncertainty; Visit; Work; arm; base; care providers; college; depressive symptoms; diabetes distress; diabetes management; diabetes self-management; emerging adult; experience; follow-up; glycemic control; group intervention; health care settings; high risk; improved; intervention participants; medical appointment; novel; novel strategies; peer; peer coaching; peer support; prevent; primary outcome; programs; psychoeducational; psychosocial; resilience; role model; secondary outcome; skills; skills training; social; social model; social situation; stress management; treatment adherence; treatment as usual; young adult

PROJECT SUMMARY/ABSTRACT Type 1 diabetes (T1D) management is challenging for young adults, who assume responsibility for self- management and transfer T1D care from the pediatric to adult healthcare system as they also manage typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended (>6 months) gaps before following up in adult care, which increase their risk for poor health outcomes and serious health complications. There are few evidence-based programs to support young adults with T1D during the transfer period between pediatric and adult care. Novel, developmentally appropriate approaches are needed to help young adults negotiate the challenges of living with T1D and complete a timely transition to adult care. The goal of the proposed study is to evaluate a new intervention for young adults with T1D that maximizes diabetes-related social support. The proposed transition intervention builds on young adults' social support network and provides them access to relevant information about T1D care in adulthood. Around the time they leave pediatric T1D care, young adults with T1D will be paired with a trained “Peer Mentor,” an experienced, slightly older young adult with T1D, who will meet with them in-person and have frequent (weekly, then monthly) contact for 12 months. During the contacts, the Peer Mentor will use strengths-based psychoeducational strategies to teach and model problem-solving and stress-management skills, encourage the young adult to seek support from their existing social support network (e.g., family, friends) and identify new sources of diabetes-related support, help the young adult prioritize T1D self-care during the very demanding young adult period, share his/her transition experiences and strategies for successfully navigating the adult healthcare system, and prepare for the first adult care visit. The Peer Mentor will be a positive role model and source of help, encouragement, and accountability around transition, with the goal of reducing isolation, promoting self-management, and preventing gaps in care. We will test this intervention with 150 young adults randomly assigned to the intervention or usual care. Our main goal is to evaluate the intervention's impact on important T1D outcomes, such as glycemic control, time to adult care, treatment adherence, and psychosocial well-being. Clinic appointment information, questionnaires, adherence data, and glycemic control biomarkers will be collected at baseline and 6 and 12 months later. The ultimate goal of this research is to validate a supportive intervention that can facilitate T1D self-management and transfer of care during the difficult young adult years and promote optimal T1D health outcomes.

项目摘要/摘要 1型糖尿病（T1D）管理是对年轻人承担自我责任的挑战 管理和转移T1D护理从小儿到成人医疗保健系统，因为它们也管理典型 发展需求（例如，社会，财务，工作/学校，居民）。许多年轻人已经延长了 （> 6个月）在跟进成人护理之前的差距，这增加了他们患健康状况不佳的风险，并且 严重的健康并发症。很少有基于证据的计划可以支持T1D的年轻人 小儿和成人护理之间的转移期。新颖，开发的适当方法是 需要帮助年轻人谈判与T1D生活的挑战，并及时过渡到 成人护理。拟议的研究的目的是评估针对T1D年轻人的新干预措施 最大化与糖尿病有关的社会支持。拟议的过渡干预是建立在年轻人的社会上的 支持网络，并为他们提供有关成年后T1D护理的相关信息的访问。周围 他们离开小儿T1D护理时，患有T1D的年轻人将与训练有素的“同伴导师”配对， 经验丰富的，年龄稍大的年轻人，患有T1D，他们会亲自与他们会面并经常与他们见面（每周， 然后每月）联系12个月。在联系人期间，同伴导师将使用基于优势的 心理教育策略，教学和模拟解决问题和压力管理技能，鼓励 年轻人从其现有的社会支持网络（例如家人，朋友）寻求支持并确定支持 与糖尿病相关的新来源的新来源，帮助年轻人优先考虑T1D自我护理 要求年轻人时期，分享他/她的过渡经验和成功导航的策略 成人医疗保健系统，并为第一次成人护理访问做准备。同伴导师将是积极的角色 围绕过渡的模型和帮助，鼓励和问责制，目的是减少 隔离，促进自我管理和防止护理差距。我们将用150测试这种干预措施 将年轻人随机分配到干预或通常的护理中。我们的主要目标是评估 干预对重要T1D结果的影响，例如血糖控制，成人护理时间，治疗 坚持和社会心理健康。诊所任命信息，问卷调查，依从性数据和 血糖控制生物标志物将在基线和6个月后收集。最终目标 研究是为了验证可以促进T1D自我管理和护理转移的支持干预措施 在艰难的年轻人年中，并促进了最佳的T1D健康结果。