Enhancing social support for diabetes self-management among men and women Veterans

加强对男性和女性退伍军人糖尿病自我管理的社会支持

• 批准号: 10186508
• 负责人: Kristen E Gray
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10186508
• 关键词: Address; Adult Children; Affect; Amputation; Behavior; Behavior Control; Behavioral; Caring; Chronic; Chronic Disease; Clinic; Clinical; Diabetes Mellitus; Disease Outcome; Doctor of Philosophy; Enrollment; Epidemiology; Eye diseases; Family; Family member; Foundations; Friends; Gender; Goals; Health; Health Services; Health Services Research; Health behavior change; Health behavior outcomes; Healthy Eating; Heart failure; Hyperlipidemia; Hypertension; Individual; Intervention; Interview; K-Series Research Career Programs; Kidney Diseases; Knowledge; Mentors; Mentorship; Methods; Monitor; Morbidity - disease rate; Obesity; Outcome; Patients; Perception; Persons; Pharmaceutical Preparations; Pilot Projects; Postdoctoral Fellow; Prevalence; Process; Public Health Schools; Qualitative Methods; Randomized Controlled Trials; Reporting; Research; Research Personnel; Resources; Self Efficacy; Self Management; Site; Social Environment; Social support; Spouses; Stroke; Telephone Interviews; Testing; Training; United States Department of Veterans Affairs; Universities; Veterans; Veterans Health Administration; Washington; Woman; Women' s Health; Women' s Health Services; arm; base; behavior test; behavioral health intervention; behavioral outcome; cardiovascular disorder risk; career; comorbidity; design; diabetes self-management; disorder control; evidence base; experience; family support; feasibility testing; gender difference; health disparity; healthy weight; implementation science; improved; innovation; medication compliance; meetings; men; mortality; pilot trial; programs; recruit; response; skills; social; treatment strategy; trial design; virtual; virtual healthcare; virtual intervention

BACKGROUND: Dr. Kristen Gray, PhD, MS is a Postdoctoral Fellow at the Seattle HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care and a Senior Fellow in the Department of Health Services in the University of Washington School of Public Health. Her research reflects a commitment to understanding and mitigating health disparities among women Veterans (WVs). The proposed Career Development Award (CDA) will provide Dr. Gray with the additional training and skills needed to build a successful career as an independent VA health services researcher developing and testing behavioral health interventions for WVs. KEY ELEMENTS OF THE RESEARCH PLAN: The goal of the proposed CDA is to develop and pilot test the feasibility, acceptability, and preliminary clinical improvement of a virtual diabetes self-management intervention tailored to men and women Veterans and their support persons. The intervention will be dyadic, including Veterans and their support persons, and will focus on enhancing supportive and reducing unsupportive behaviors in order to improve Veterans' self-management behaviors and disease outcomes. Examination of gender differences in outcomes is a key focus of the proposal because: (1) the VA Evidence- based Synthesis program recently identified a gap in knowledge of gender differences in non-pharmacologic diabetes interventions, and (2) VA trials of self-management interventions have included few or no women, precluding examination of gender differences, The specific aims of the proposal are to: (1) characterize women and men Veterans' social support resources, perceptions of supportive and unsupportive behaviors related to diabetes self-management, and facilitators and barriers to engaging in a partnered self-management intervention through qualitative telephone interviews; (2) identify support person perceptions of supportive and unsupportive behaviors for Veterans' self- management and facilitators and barriers to engaging in a partnered self-management intervention through qualitative interviews; and (3) evaluate feasibility, acceptability, and preliminary clinical improvement of a partnered diabetes self-management intervention in a single-arm pilot trial. Based on findings from Aims 1 and 2, the intervention will be tailored to facilitate recruitment and retention of Veterans and support persons in the Aim 3 pilot study. An equal number of men and women Veterans will be enrolled in the pilot to enable examination of gender differences in feasibility, acceptability, and clinical improvement. The resulting product will be a refined intervention, which will be tested in a larger, multi-site randomized controlled trial. TRAINING: In order to accomplish CDA and career goals, Dr. Gray will seek additional training to strengthen her health services research skills in: 1) qualitative methods, 2) health behavior change, and 3) trial design. She will also begin introductory training in implementation science. She will participate in coursework at the University of Washington, local and national trainings, clinical shadowing, and other professional activities to achieve these training goals. MENTORS: Dr. Gray is supported in her training and research by a diverse and well-qualified set of mentors, including experts in diabetes (Dr. Karin Nelson), qualitative methods (Dr. Corrine Voils); behavioral randomized controlled trials (Drs. Lori Basian and Voils), and virtual health care (Dr. John Fortney). Additional CDA consultants will provide guidance in chronic disease self-management interventions (Dr. Michele Heisler). IMPACT: This CDA will accelerate Dr. Gray's independence as a VA health services investigator dedicated to advancing the health of WVs. The research proposed, in combination with the mentorship and training, will provide the necessary experience and knowledge to cultivate an independent program of health services research focused on developing and testing behavioral health interventions for WVs.

背景：MS Kristen Gray博士是西雅图HSR＆D中心的博士后研究员 以资深和价值驱动的护理和卫生部的高级研究员的创新 华盛顿大学公共卫生学院的服务。她的研究反映了对 了解和减轻退伍军人（WVS）的健康差异。拟议的职业 开发奖（CDA）将为格雷博士提供建立额外的培训和技能 作为独立VA卫生服务研究人员开发和测试行为健康的成功职业生涯 WVS的干预措施。 研究计划的关键要素：拟议的CDA的目标是开发和试点测试 虚拟糖尿病自我管理的可行性，可接受性和初步临床改善 针对男女退伍军人及其支持人员量身定制的干预措施。干预将是二元的 包括退伍军人及其支持人员，并将专注于增强支持和减少 为了改善退伍军人的自我管理行为和疾病的结果，没有支持的行为。 对结局的性别差异的检查是该提案的重点，因为：（1）VA证据 - 基于基于非药物的性别差异知识的知识差距 糖尿病干预措施和（2）自我管理干预措施的VA试验很少或没有女性， 排除对性别差异的检查， 该提案的具体目的是：（1）男女退伍军人的社会支持资源的特征， 对与糖尿病自我管理和促进者有关的支持和不支持行为的看法以及促进者 以及通过定性电话采访进行合作的自我管理干预措施的障碍； （2）确定支持者对退伍军人自我的支持和不支持行为的看法 管理和促进者以及通过 定性访谈； （3）评估可行性，可接受性和初步临床改善 在单臂试验试验中伙伴糖尿病自我管理干预措施。根据目标1和 2，干预措施将量身定制，以促进退伍军人的招募和保留，并在 AIM 3试点研究。同等数量的男女退伍军人将被招募到飞行员中以启用 检查可行性，可接受性和临床改善的性别差异。产生的产品 将是一种精致的干预措施，将在较大的多站点随机对照试验中进行测试。 培训：为了实现CDA和职业目标，格雷博士将寻求额外的培训以加强 她的健康服务研究技能：1）定性方法，2）健康行为改变，3）试验设计。 她还将开始实施科学培训。她将参加课程 华盛顿大学，本地和国家培训，临床阴影以及其他专业活动 实现这些培训目标。 导师：格雷博士在她的培训和研究中得到了多样化且合格的导师的支持， 包括糖尿病专家（Karin Nelson博士），定性方法（Corrine Voils博士）；行为随机 对照试验（Lori Basian和Voils博士）和虚拟医疗保健（John Fortney博士）。其他CDA 顾问将为慢性疾病自我管理干预措施提供指导（Michele Heisler博士）。 影响：该CDA将加速Gray博士的独立性，作为VA健康服务调查员致力于 提高WVS的健康状况。该研究提出，结合指导和培训，将 提供必要的经验和知识来培养独立的卫生服务计划 研究重点是开发和测试WVS行为健康干预措施。