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: 10449583
• 负责人: Brynn E Marks
• 金额: $ 18.37万
• 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/10449583
• 关键词: 12 year old; Acute; Address; Adult; Advisory Committees; Behavior; Behavior Therapy; Behavioral; Caring; Child; Child Care; Childhood; Chronic; Clinical; Controlled Clinical Trials; Data; Development; Devices; Diabetes Mellitus; Education; Educational Curriculum; 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; Leadership; Learning; Medical; Medical Education; Mentors; Mentorship; Methodology; Multicenter Studies; 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; base; career development; clinical practice; design; diabetes educator; diabetes management; diabetes self-management; early adolescence; education research; eligible participant; experience; glucose monitor; glycemic control; health related quality of life; improved; improved outcome; innovation; motivational enhancement therapy; novel; parental monitoring; patient oriented; 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.

项目概要/摘要 尽管越来越多地使用胰岛素泵 (IP) 和连续血糖监测仪 (CGM) 来治疗儿科 1 型糖尿病 (T1D) 管理和研究显示使用这些设备的好处，现实世界的血糖 近年来，青少年 T1D 患者的控制情况有所恶化。尽管血糖控制缺乏改善 这些技术的使用增加表明接受常规临床 T1D 护理的青少年没有意识到 IP 和 CGM 的全部潜力。尽管更多的青少年和父母的糖尿病知识与更好的糖尿病相关 血糖控制，仅靠教育不足以带来改善所需的行为改变 T1D 的结果。心理教育认识到需要将教育和行为方法结合起来， 包括解决问题和设定目标，支持父母制定最佳的 T1D 管理 接近。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 开发以家庭为中心的创新心理教育工具，解决行为和知识问题 将有助于充分发挥糖尿病技术的潜力，改善血糖控制和生活质量，同时 最终预防或延缓 T1D 急性和长期并发症的发展。 该提案的科学目标是确定 8-12 岁儿童家长未满足的心理教育需求 使用 IP 和 CGM 进行儿科 T1D 管理，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 的结果。在目标 1 中， 对涉及 T1D 儿童、其父母和糖尿病临床医生的访谈进行语义内容分析 用于识别使用这些技术的父母和儿童未满足的教育和行为需求。我们 之前为临床医生开发了应用程序提供的 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意见，以适应现有的课程，以满足家长的具体需求 患有 T1D 的学龄儿童。最后，在目标 3 中，我们将试点这种心理教育干预措施。家长会 完成 4 个月的应用程序提供的心理教育课程后，两人还将患上糖尿病 接受过动机性访谈培训的教育工作者，以强化在课堂上学到的知识和解决问题的技能 课程，将它们应用于个人 IP 和 CGM 数据。在我的导师和顾问的支持下 委员会由 T1D 行为干预、医疗和家庭教育领域的专家组成， 定性研究，我将实现学习定性和定性研究先进技术的职业发展目标 定量研究，发展面向家庭的心理教育干预方面的专业知识，并培养 将我的发现转化为临床实践所需的领导技能。这个指导性职业发展奖 将支持我作为一名独立调查员的发展，能够利用未满足的潜力 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。