Glu-COACH: a peer-mentoring intervention to reduce disparities in CGM use in adolescents with type 1 diabetes

Glu-COACH：一种同伴指导干预措施，旨在减少 1 型糖尿病青少年 CGM 使用差异

• 批准号: 10708180
• 负责人: STUART ALAN WEINZIMER
• 金额: $ 47.73万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708180
• 关键词: AIDS prevention; Address; Adolescent; Adoption; Age; Alcohol consumption; Attitude; Behavior; Black race; Blood Glucose; Caring; Chronic; Chronic Disease; Clinical; Clinical Management; Clinical Trials; Collaborations; Communication; Conduct Clinical Trials; Continuous Glucose Monitor; Control Groups; Development; Devices; Diabetes Mellitus; Disease Management; Disparity; Distress; Emotional; Enrollment; Ethnic Population; Evaluation Studies; Feasibility Studies; Feeling; Frustration; Future; Glucose; Health; Health Personnel; Hypoglycemia; Insulin-Dependent Diabetes Mellitus; Insurance Coverage; Intervention; Latinx; Life Style; Maintenance; Metabolic; Minority; Modeling; Monitor; Multi-Institutional Clinical Trial; Outcome; Parents; Participant; Patients; Pattern; Persons; Phase; Pilot Projects; Population; Privatization; Problem Solving; Process; Protocols documentation; Quality of life; Randomized; Randomized, Controlled Trials; Recommendation; Reduce health disparities; Reporting; Research; Research Design; Sampling; Self Efficacy; Self Management; Site; Socioeconomic Factors; Structure; Technology; Teenagers; Time; Training; Validation; Work; Youth; age group; behavioral health; behavioral outcome; clinical care; comparison control; diabetes distress; diabetes management; disparity reduction; drug abuse prevention; efficacy evaluation; ethnic disparity; experience; glycemic control; health inequalities; health related quality of life; improved; innovation; meetings; monitoring device; peer coaching; peer support; primary outcome; programs; racial disparity; racial population; response; role model; scale up; secondary outcome; smoking cessation; social media; social situation; socioeconomics; standard care; standard of care; trend; uptake; young adult

PROJECT SUMMARY Adolescents with type 1 diabetes struggle more than any other age group to meet recommended glycemic targets. Continuous glucose monitoring devices, which enable real-time determination and communication of blood glucose levels, identification of trends, alerts, and alarms, and remote communication and monitoring, have improved metabolic and lifestyle outcomes and have markedly transformed the clinical management of diabetes in youth. However, these technological improvements have not benefited all populations similarly: lower rates of uptake and continued use of these devices in Black and Latinx young people have exacerbated pre- existing racial disparities in diabetes care and outcomes. Beyond socioeconomic issues such as access, developmentally and culturally specific factors relating to burden, diabetes distress, and self-efficacy are modifiable targets for specific and innovative interventions. Structured peer mentoring programs have been successfully employed in other chronic illness models to improve attitudes and behaviors around disease management. Using a stakeholder engagement approach, we will develop, optimize, and evaluate a peer- support intervention, Glu-COACH, to improve the uptake and maintenance of CGM use in Black and Latinx adolescents with type 1 diabetes. The input from a stakeholder panel representing patients, parents, and clinicians will inform each phase of the study. In Phase 1, we will collaboratively develop Glu-COACH and finalize study protocols with our stakeholders. In Phase 2, we will conduct a randomized controlled pilot study (n=50) comparing Glu-COACH to an enhanced standard care control group, convening quarterly research progress meetings with our stakeholders for ongoing collaboration. We hypothesize that the support, validation, identification, vicarious experience, and role modeling provided by trained peer mentors of the same cultural identity will significantly improve our primary aim of CGM use in Glu-COACH participants compared to the control group. We will also examine the effects of the Glu-COACH intervention on glycemic outcomes, such as time in range, mean glucose, and A1c, and behavioral outcomes, such as diabetes-related self-efficacy and distress, as well as benefits and burdens related to CGM use. Finally, we will critically examine the feasibility, acceptability, and implementation of the Glu-COACH intervention. This intervention will be upscaled and evaluated in a subsequent multi-site randomized controlled trial if proven effective.

项目摘要 患有1型糖尿病的青少年比其他任何年龄段的糖尿病挣扎更多 目标。连续的葡萄糖监测设备，可以实时确定和交流 血糖水平，趋势识别，警报和警报以及远程通信和监视， 已经改善了新陈代谢和生活方式的结果，并显着改变了 青年糖尿病。但是，这些技术的改进并未使所有人口受益类似：较低 在黑人和拉丁裔年轻人中摄取和继续使用这些设备的发生率使 糖尿病护理和结果中现有的种族差异。超越社会经济问题，例如访问， 与负担，糖尿病困扰和自我效能相关的发展和文化特定因素是 针对特定和创新干预措施的可修改目标。结构化的同行指导计划已经 成功地在其他慢性病模型中使用，以改善疾病的态度和行为 管理。使用利益相关者参与方法，我们将开发，优化和评估同行 支持干预措施，Glu-Coach，以改善CGM使用黑色和拉丁裔使用CGM的吸收和维护 患有1型糖尿病的青少年。利益相关者小组的意见，代表患者，父母和 临床医生将告知研究的每个阶段。在第1阶段，我们将协作开发Glu-Coach并最终确定 与我们的利益相关者一起学习协议。在第2阶段，我们将进行一项随机对照的初步研究（n = 50） 将GLU教练与增强的标准护理对照组进行比较，召集季度研究进度 与我们的利益相关者会议进行持续合作。我们假设支持，验证， 同一文化的训练有素的同伴导师提供的身份，替代经验和榜样 与对照相比 团体。我们还将研究GLU教练干预对血糖结果的影响，例如 范围，平均葡萄糖和A1C以及行为结果，例如与糖尿病相关的自我效能和困扰， 以及与CGM使用相关的好处和负担。最后，我们将批判性地研究可行性，可接受性， 并实施GLU教练干预。该干预措施将在 随后的多站点随机对照试验如果被证明有效。