Prevention of Self-care Deterioration in Early Adolescents with Diabetes

预防早期糖尿病青少年的自我保健恶化

基本信息

批准号：
8054193
负责人：
CLARISSA S HOLMES
金额：
$ 57.04万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8054193
关键词：
14 year old Adolescent Adopted Adverse event Aftercare Age Americas Attention Behavior Behavior Therapy Behavioral Biological Biometry Blood Glucose Boxing Caring Child Childhood Cognitive Communication Conflict (Psychology)Control Groups Coping Skills Data Data Analyses Deterioration Development Diabetes Mellitus Disease Disease Management Educational process of instructing Environment Equation Family Frequencies Glycols Goals Growth Healthcare Hemoglobin concentration result Hour Instruction Insulin-Dependent Diabetes Mellitus Intervention Interview Location Maintenance Maps Measurement Measures Medical Memory Methodology Minority Modeling Office Visits Outcome Parenting behavior Parents Pattern Physiological Adaptation Prevention Prevention program Preventive Intervention Problem Solving Process Questionnaires Relative (related person)Sampling Self Care Sensitivity and Specificity Site Specificity Stress Supervision Techniques Telephone Interviews Time Translating Translations Treatment Efficacy Virulent Youth aged base biopsychosocial clinical care conflict resolution design diet and exercise early adolescence expectation follow-up glucose monitor glycemic control high risk improved innovation novel parental involvement post intervention psychologic psychosocial response skills treatment effect

项目摘要

DESCRIPTION (provided by applicant): Pediatric diabetes looms as an emerging health care crisis in America. Both type 1 and 2 diabetes share common developmental issues that require successful adolescent/parent interactions to promote healthy self-care, particularly in diet and exercise behaviors. A Prevention Program to avoid adolescent self-care deterioration in T1D, the more virulent form, is proposed with a 3-site study that has a 23% minority representation. To facilitate maximum translation to routine clinical care, a brief, office-based treatment is planned (4, 30-min sessions) that will incorporate instruction in authoritative parenting, along with relevant coping skills of communication, problem solving, conflict resolution, and cognitive refraining. Treatment will be accompanied by comprehensive assessment to describe 1) correlates of self-care, including novel memory predictors, 2) moderators of treatment efficacy, and 3) innovative assessment of immediate response-to-treatment (RTT) behavioral trajectories. RTT will use data from 24-hour disease care interviews obtained during treatment inter-sessions for precise behavioral tracking of immediate session efficacy. We will map behavioral trajectories in response to treatment sessions to better understand what previously has been a 'black box' of year-long treatment. The proposed multi-site study with 3 locations should facilitate generalizability of results and the resultant large N of 190 should increase sensitivity to treatment effects. Powerful latent growth curve analyses and structural equation modeling will be utilized for data analysis, along with more traditional statistical techniques. A comprehensive biopsychosocial framework will be adopted that includes biological, psychological and sociofamial measurements of youths with diabetes and their parents. Approximately 190 11- to 14-year-olds will be assigned in a 5:1 proportion to either brief, office-based treatment or an attention control group. Previously, treatment groups have spanned wide age ranges such that the proposed narrow age range in the early adolescent years (11-14) should minimize broad developmental differences that may have obscured earlier results. Most subjects will be followed for up to 2 years' post-intervention. Better biometric outcomes (blood glucose levels, glycohemoglobin levels, fewer adverse events), along with better psychosocial outcomes (continued parental involvement in disease care, more frequent/better disease care), is predicted relative the attention control group.

描述（由申请人提供）：小儿糖尿病隐约可作为美国新兴的医疗危机。 1型和2型糖尿病都有常见的发育问题，需要成功的青少年/父母互动以促进健康的自我保健，尤其是在饮食和运动行为方面。通过一项具有23％少数族裔代表的3个站点的研究提出了一个预防计划，旨在避免T1D的青春期自我保健恶化，这是一种更具毒性的形式。为了最大程度地翻译为常规临床护理，计划了一项简短的基于办公室的治疗（4，30分钟的课程），该治疗将在权威育儿中纳入教学，以及相关的沟通，解决问题，解决冲突，解决冲突和认知拒绝的相关应对能力。治疗将伴随着全面的评估，以描述1）自我护理的相关性，包括新的记忆预测因子，2）治疗功效的主持人，以及3）对即时响应对处理（RTT）行为轨迹的创新评估。 RTT将使用治疗期间24小时疾病护理访谈中的数据，以精确的行为跟踪即时会话功效。我们将响应治疗课程来绘制行为轨迹，以更好地了解以前的“黑匣子”为期一年的治疗。拟议的具有3个位置的多站点研究应促进结果的普遍性，最终的190个n应提高对治疗效果的敏感性。强大的潜在生长曲线分析和结构方程模型将用于数据分析，以及更传统的统计技术。将采用一个全面的生物心理社会框架，其中包括对糖尿病及其父母的年轻人的生物学，心理和社会学测量。大约190个11至14岁的孩子将以5：1的比例分配与简短，基于办公室的治疗或注意力控制组的比例。以前，治疗组跨越了较广泛的年龄范围，以至于青少年早期（11-14）提出的狭窄年龄范围应最大程度地减少可能掩盖早期结果的广泛发育差异。大多数受试者将在干预后最多遵循2年。预测相对于注意力控制组的生物识别结果（血糖水平，血糖水平，较少的不良事件）以及更好的社会心理结局（持续的父母参与疾病护理，更频繁/更好的疾病护理）。