Developing a diabetes self-management mHealth simulation platform for youth

项目摘要 对于美国150万1型糖尿病（T1 D）患者， 血糖控制接近正常，通常通过糖化血红蛋白（A1 c）测量，以防止微血管 和大血管并发症的可能性尽管最近取得了进展， 管理糖尿病的技术（即，胰岛素泵，动态血糖监测（CGM），混合闭环 (HCL)然而，70%的1型糖尿病（T1 D）患者没有达到他们的A1 c目标。青少年票价 比儿童和成人更差，目前只有17%的人实现了目标。胰岛素泵治疗是一种 生理形式的胰岛素输送比每天多次注射，但这些复杂的机器严重依赖于 个体利用和自我管理行为。在这个指导病人为导向的研究生涯 发展奖（K23），我们提出了三个不同的，但互补的研究。首先，我们来看看小说。 青少年前和青少年糖尿病器械自我管理方面，通过对 一个大型数据集，结合了糖尿病设备的自我管理，利用和葡萄糖数据，从青年的 糖尿病设备（例如胰岛素泵、CGM、HCL）。其次，我们将扩展功能并测试 在青少年（10-18岁）中使用现有的移动健康糖尿病教育模拟平台（A1 Control）， T1 D使用参与式设计技术，包括共同设计研讨会和实验室可用性测试。第三、 我们将进行一项试点研究，以评估移动医疗的可行性、持续参与和影响。 对患有T1 D的青少年（10-18岁）进行干预。这项拟议的培训奖励与NINR的一致， 使命是支持建立模型或提高对自我管理行为的理解的研究， 在推进数据分析技术以改善健康方面的跨领域协调。职业发展 目标是：（1）发展先进的设备和传感器数据分析技能;（2）提高知识和 参与式设计方法的技能;（3）获得临床试验干预开发的技能， 试验.职业目标将通过正式教学和非正式培训相结合来实现; 参加国家会议和讲习班;以及在 在以患者为中心的技术开发领域（Mion和Happ）， 数据分析和二次分析（Shoben和Mion），以及临床试验研究（Mion、Dungan、Happ和 Shoben）。候选人的导师和合作者组成了一个跨学科的团队， 内分泌学、工程学和公共卫生学。从这一职业中获得的技能、经验和培训 发展奖将定位候选人为一个成功的职业生涯作为一个独立的调查重点 论慢性病自我管理的科学与技术利用与发展 组织未来的大规模试验，旨在改善糖尿病患者的预后。

PROJECT SUMMARY For the 1.5 million individuals in the United States living with type 1 diabetes (T1D) the importance of maintaining near normal glycemic control, typically measured by glycosylated hemoglobin (A1c), to prevent microvascular and macrovascular complications is well established. Despite recent advancements and increased use of technologies to manage diabetes (i.e., insulin pump, continuous glucose monitoring (CGM), Hybrid Closed Loop (HCL) systems), 70% of individuals with type 1 diabetes (T1D) do not meet their A1c targets. Adolescents fare worse than children and adults with only 17% currently achieving targets. Insulin pump therapy is a more physiologic form of insulin delivery than multiple daily injections, yet these complex machines rely heavily on individual utilization and self-management behaviors. In this Mentored Patient-Oriented Research Career Development Award (K23) we propose three distinct but complementary studies. First, we will examine novel aspects of pre-teen and adolescent diabetes device self-management by conducting a secondary analysis of a large dataset that combines diabetes device self-management, utilization and glucose data from the youth’s diabetes device (e.g. insulin pump, CGM, HCL). Second, we will extend the functionality and test the validity of an existing mHealth diabetes education simulation platform (A1Control) among youth (10-18 years of age) with T1D using participatory design techniques including co-design workshops, and laboratory usability testing. Third, we will conduct a pilot study to assess the feasibility, sustained engagement and impact of the mHealth intervention among youth (10-18 years of age) with T1D. This proposed training award is congruent with NINR’s mission to support research that models or improves understanding of self-management behaviors as well as cross-cutting alignment in advancing data analytics for technology to improve health. Career development objectives are: (1) developing advanced device and sensor data analytics skills; (2) enhancing knowledge and skills of participatory design methods; and, (3) acquiring skills in clinical trials intervention development and testing. Career objectives will be accomplished through a combination of formal didactic and informal trainings; participation in national conferences and workshops; and hands-on research training under the mentorship of an accomplished team of scientists in the field of patient centered technology development (Mion and Happ), data analytics and secondary analysis (Shoben and Mion), and clinical trials research (Mion, Dungan, Happ and Shoben). The candidate’s mentors and collaborators comprise a transdisciplinary team from nursing, endocrinology, engineering, and public health. The skills, experience, and training gained from this career development award will position the candidate for a successful career as an independent investigator focused on the science of chronic disease self-management and technology utilization with development and organization of future large scale trials aimed at fostering improved outcomes for individuals with diabetes.