Optimizing Use of Advanced Diabetes Technology for Self-Management in Adolescents with Type 1 Diabetes: Integration of Real-Time Glucose and Narrative Data

优化使用先进糖尿病技术对 1 型糖尿病青少年进行自我管理：实时血糖和叙述数据的集成

• 批准号: 10569293
• 负责人: Melissa DeJonckheere
• 金额: $ 15.79万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569293
• 关键词: 18 year old; Acute; Adherence; Adolescence; Adolescent; Adolescent Development; Adolescent Health Services; Affect; Age; Award; Behavior; Behavioral; Biological Process; Blood Glucose Self-Monitoring; Cardiovascular Diseases; Caring; Child; Childhood; Chronic; Clinical Trials; Collection; Communities; Complex; Continuous Glucose Monitor; Data; Data Collection; Dedications; Development; Development Plans; Devices; Diabetes Mellitus; Diabetic Ketoacidosis; Ecological momentary assessment; Environment; Environmental Risk Factor; Evaluation; Family Practice; Feedback; Glucose; Glycosylated hemoglobin A; Goals; Health; Hormonal Change; Hypoglycemia; Incidence; Individual; Institution; Insulin; Insulin Infusion Systems; Insulin Resistance; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Trial; K-Series Research Career Programs; Kidney Diseases; Knowledge; Knowledge acquisition; Learning; Life; Life Expectancy; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Michigan; Morbidity - disease rate; Natural Language Processing; Neuropathy; Outcome; Patients; Pilot Projects; Problem Solving; Process; Psychosocial Factor; Pump; Quality of life; Recommendation; Regimen; Regulation; Research; Research Personnel; Retinal Diseases; Risk; Self Management; Short-Term Memory; Structure; Techniques; Technology; Testing; Theory of Change; Time; Training; Translating; Treatment Protocols; United States; Universities; Well in self; acceptability and feasibility; adolescent health; adolescent health outcomes; age group; arm; behavior change; career; career development; critical period; data integration; data streams; design; diabetes distress; education research; efficacy outcomes; executive function; experience; feasibility testing; glycemic control; hands-on learning; high risk population; implementation strategy; improved; insight; intervention mapping; longitudinal analysis; macrovascular disease; medical schools; mobile application; mortality; pilot test; prevent; primary outcome; psychosocial; psychosocial wellbeing; skills; theories

PROJECT SUMMARY / ABSTRACT Type 1 diabetes (T1D) is one of the most common pediatric chronic conditions, affecting 187,000 children and adolescents in the United States. It is a complex and demanding condition that requires intensive self- management regimens to prevent complications. Despite improvements in diabetes technology to support self- management, nearly 85% of adolescents with T1D fail to meet recommended glycemic targets, putting them at risk for complications, reduced life expectancy, and diminished quality of life. Understanding and improving how adolescents are using advanced diabetes technology to perform self-management tasks in real-time can greatly improve the health of this high-risk population. The specific aims of the proposed research are: 1) Collect and integrate data streams from both continuous glucose monitoring (CGM) and ecological momentary assessment (EMA) to gain a new understanding of how adolescents use advanced diabetes technology in real time for self-management, and to identify potential intervention targets and strategies, 2) Design an ecological momentary intervention to improve self-management behaviors, 3) Pilot test the feasibility, acceptability, and potential efficacy of the new ecological momentary intervention to improve glycemic control. Upon completion, our team will prepare and submit an R01 proposal for a full-scale trial of the intervention to improve glycemic control and psychosocial outcomes. Candidate: Dr. DeJonckheere is an adolescent health services researcher and early career investigator focused on improving health outcomes for adolescents with T1D. Her career goal is to become an independent investigator with expertise in real-time assessment to develop theory- based interventions that optimize use of advanced diabetes technology for self-management. Building on her experience in educational research and adolescent engagement, this K01 award will support her to develop and evaluate self-management interventions to improve how adolescents with T1D use diabetes technology in everyday life. The specific aims are aligned with training aims in the career development plan: 1) develop expertise in real-time data collection through mobile applications to study how adolescents use advanced diabetes technology and data; 2) gain skills in the use of natural language processing techniques to rapidly analyze longitudinal, real-time qualitative data; 3) build skills in the development and testing of evidence- and theory-based intervention for adolescents with T1D; and 4) acquire knowledge in the biological processes and standards of care of T1D in adolescence. The career development plan will support Dr. DeJonckheere to achieve her training goals through dedicated mentorship by a team of leading investigators, advanced didactic coursework, execution of the proposed research plan, and participation in the broader scientific community. The University of Michigan, University of Michigan Medical School, and Department of Family Medicine provide strong institutional support and an excellent environment to complete the proposed career development award.

项目概要/摘要 1 型糖尿病 (T1D) 是最常见的儿科慢性病之一，影响着 187,000 名儿童和 美国的青少年。这是一种复杂而苛刻的情况，需要大量的自我修复 预防并发症的管理方案。尽管糖尿病技术有所进步以支持自我治疗 管理方面，近 85% 的 T1D 青少年未能达到建议的血糖目标，使他们处于 并发症风险、预期寿命缩短和生活质量下降。理解和改进 青少年如何使用先进的糖尿病技术来实时执行自我管理任务 大大改善了这一高危人群的健康状况。拟议研究的具体目标是：1） 收集并整合来自连续血糖监测 (CGM) 和生态瞬时监测的数据流 评估 (EMA)，以重新了解青少年如何实际使用先进的糖尿病技术 自我管理的时间，并确定潜在的干预目标和策略，2）设计生态 短暂干预以改善自我管理行为，3）试点测试可行性、可接受性和 新生态瞬时干预改善血糖控制的潜在功效。完成后， 我们的团队将准备并提交 R01 提案，以进行全面的改善血糖干预试验 控制和社会心理结果。候选人：DeJonckheere 博士是一名青少年健康服务人员 研究员和早期职业调查员，专注于改善 T1D 青少年的健康结果。她 职业目标是成为一名独立调查员，具有实时评估方面的专业知识，以发展理论- 基于干预措施，优化使用先进的糖尿病技术进行自我管理。以她为基础 在教育研究和青少年参与方面的经验，这个 K01 奖将支持她发展 并评估自我管理干预措施，以改善患有 T1D 的青少年如何使用糖尿病技术 日常生活。具体目标与职业发展计划中的培训目标一致：1）发展 通过移动应用程序收集实时数据的专业知识，以研究青少年如何使用先进的 糖尿病技术和数据； 2）获得使用自然语言处理技术快速 分析纵向、实时定性数据； 3）培养开发和测试证据的技能 对患有 T1D 的青少年进行基于理论的干预； 4) 获取生物过程方面的知识 青春期 T1D 护理标准。职业发展计划将支持 DeJonckheere 博士 通过由主要研究人员、高级教学人员组成的团队的专门指导来实现她的培训目标 课程作业、拟议研究计划的执行以及更广泛的科学界的参与。 密歇根大学、密歇根大学医学院和家庭医学系提供 强大的机构支持和优良的环境来完成拟议的职业发展奖。