Improving Self-Regulation and Social Support for Type 1 Diabetes During Emerging Adulthood

改善成年初期 1 型糖尿病的自我调节和社会支持

• 批准号: 10752415
• 负责人: Cynthia A Berg
• 金额: $ 7.52万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10752415
• 关键词: Address; Adolescence; Adult; American; Blood Glucose; Childhood; Continuous Glucose Monitor; Data; Diet; Disclosure; Ethnic Origin; Failure; Family; Friends; Goals; Informal Social Control; Insulin-Dependent Diabetes Mellitus; Intervention; Life; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Persons; Public Health; Recommendation; Regulation; Reporting; Research; Resources; Risk; Sampling; Self Care; Self Efficacy; Self Management; Site; Social support; Telephone; Text Messaging; Time; Treatment Efficacy; Work; blood glucose regulation; college; comparison intervention; diabetes distress; diabetes management; effective intervention; efficacy testing; emerging adult; emerging adulthood; high risk; improved; innovation; intervention effect; meetings; parental involvement; racial diversity; recruit; skills; social; social relationships; theories; treatment as usual; Address; Adolescence; Adult; American; Blood Glucose; Childhood; Continuous Glucose Monitor; Data; Diet; Disclosure; Ethnic Origin; Failure; Family; Friends; Goals; Informal Social Control; Insulin-Dependent Diabetes Mellitus; Intervention; Life; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Persons; Public Health; Recommendation; Regulation; Reporting; Research; Resources; Risk; Sampling; Self Care; Self Efficacy; Self Management; Site; Social support; Telephone; Text Messaging; Time; Treatment Efficacy; Work; blood glucose regulation; college; comparison intervention; diabetes distress; diabetes management; effective intervention; efficacy testing; emerging adult; emerging adulthood; high risk; improved; innovation; intervention effect; meetings; parental involvement; racial diversity; recruit; skills; social; social relationships; theories; treatment as usual

PROJECT SUMMARY Type 1 diabetes (T1D) is a significant public health problem, with some three million Americans living with the illness. Although extensive research has examined factors that facilitate or impede T1D management during childhood and adolescence, much less is known about the high-risk time of emerging adulthood. Less than one-third of emerging adults engage in self-management consistent with recommendations for blood glucose checking and diet, and only 17% meet recommendations for blood glucose control, placing emerging adults at risk for serious long-term complications. We theorize these risks occur because emerging adults are still developing the self-regulation skills to manage T1D independently and lack the necessary social resources to manage their illness as parental involvement declines and new relationships at work and in college occur. There is a critical need to intervene, however, few high-quality interventions exist to address the unique needs of emerging adults with T1D. The scientific premise is that an intervention targeting self-regulation (setting goals, planning) and social-regulation (disclosing to others so they can provide social support) will be beneficial for meeting the challenges of managing T1D during emerging adulthood. The research is innovative in testing the efficacy of a theory-based intervention to target self-regulation and leverage social relationships in the daily lives of a sample of ethnically/racially diverse emerging adults. FAMS-T1D is a newly adapted intervention based on a highly effective intervention (FAMS-Family/friend Activation to Motivate Self-Care) developed for adults with type 2 diabetes (T2D) that involves three components: 1) phone-based coaching to improve patients' skills in goal pursuit and managing social relationships, 2) text messaging to patients to facilitate self- regulation and social-regulation, and 3) text messaging to a support person (SP) to improve dialogue with and support for the patient. The study compares the intervention to control (enhanced treatment as usual). Extensive preliminary data of the investigative team support the need for the intervention in emerging adults with T1D and the efficacy of the intervention for adults with T2D. In Aim 1, we evaluate the effects of the 6- month intervention on A1c, self-management, and diabetes distress at 6-, 9-, and 12-months post baseline with a diverse sample of 280 emerging adults and SPs recruited across two sites. In Aim 2, we examine whether the effects on outcomes occur through improvements in patients' reports of self-regulation (planning, self- efficacy, self-regulation failures) and social-regulation (disclosure to others; helpful and harmful involvement of family and friends). In Aim 3, we evaluate how the intervention improves SP reports of their involvement without increasing SP burden. In Aim 4, we explore the time course of intervention effects on time in range using continuous glucose monitoring data from a subsample of participants. The intervention has the potential for high impact and broad reach as it helps emerging adults with T1D develop skills that can be leveraged in multiple social settings, new relationships, and across other domains of life.

项目摘要 1型糖尿病（T1D）是一个重大的公共卫生问题，约有300万美国人居住 疾病。尽管广泛的研究已经检查了促进或阻碍T1D管理的因素 童年和青春期，对新兴成年的高风险时间知之甚少。少于 三分之一的新兴成年人从事与血糖建议一致的自我管理 检查和饮食，只有17％的人符合血糖控制的建议，将新兴的成年人放在 严重的长期并发症的风险。我们认为这些风险的理论是因为新兴的成年人仍然是 发展自我调节技能以独立管理T1D，缺乏必要的社会资源来 当父母的参与下降，工作和大学中的新关系时，将他们的疾病处理。 迫切需要干预，但是，很少有高质量的干预措施可以满足独特的需求 带有T1D的新兴成年人的科学的前提是针对自我调节的干预措施（设置 目标，计划）和社会监管（向他人披露以提供社会支持）将是有益的 满足在成年期间管理T1D的挑战。该研究在测试方面具有创新性 基于理论的干预措施针对自我调节并利用日常社会关系的功效 种族/种族多样化的成年人的样本的生活。 FAMS-T1D是新的改编干预措施 基于高效的干预（FAMS家庭/朋友激活以激发自我保健） 涉及三个组成部分的2型糖尿病（T2D）的成年人：1）基于电话的教练以改进 患者在目标追求和管理社会关系方面的技能，2）给患者的文本消息传递以促进自我 监管和社会监管，以及3）给支持人员（SP）的文本消息传递，以改善与和 支持患者。该研究将干预措施与对照进行比较（照常增强治疗）。 调查小组的广泛初步数据支持对新兴成年人进行干预的需求 具有T1D和T2D成人干预的功效。在AIM 1中，我们评估了6-的影响 在基线后6，9和12个月对A1C，自我管理和糖尿病困扰的月份干预 在两个地点招募了280名新兴成年人和SP的不同样本。在AIM 2中，我们检查了是否 通过改善患者自我调节的报告（计划，自我自我调查），对结局的影响发生 功效，自我调节失败）和社会监管（向他人披露；有益和有害的参与 家人和朋友）。在AIM 3中，我们评估干预措施如何改善SP的参与报告 没有增加SP负担。在AIM 4中，我们探讨了干预效果的时间过程 使用来自参与者子样本的连续葡萄糖监测数据。干预有潜力 对于高影响力和广泛的影响力，因为它可以帮助新兴的成年人具有T1D的发展技能 多种社交环境，新的关系以及生活的其他领域。