Mobile Phone Support for Adults and Support Persons to Live Well with Diabetes

为成年人提供手机支持并支持糖尿病患者过上健康的生活

• 批准号: 10296301
• 负责人: Lindsay S. Mayberry
• 金额: $ 22.33万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10296301
• 关键词: Academic Medical Centers; Adult; Behavior Therapy; Car Phone; Caring; Clinical; Cluster Analysis; Complex; Control Groups; Data; Data Analyses; Diabetes Mellitus; Dimensions; Enrollment; Ensure; Family; Family member; Friends; Future; Genetic; Glycosylated hemoglobin A; Heterogeneity; Individual; Individual Differences; Intervention; Interview; Knowledge; Lead; Learning; Methods; Modernization; Modification; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Randomized Controlled Trials; Research; Role; Sampling; Science; Self Care; Self Efficacy; Social Environment; Surveys; Testing; Time; Typology; Work; analytical method; cohort; design; diabetes distress; diabetes management; diabetes self-management; effective intervention; efficacy testing; ethnic minority population; experience; family structure; family support; follow-up; glycemic control; implementation efforts; improved; interest; intervention participants; learning engagement; low socioeconomic status; medication compliance; novel; post intervention; precision medicine; preference; primary outcome; prospective; racial and ethnic; recruit; secondary outcome; treatment as usual; treatment effect; trial comparing

Project Summary We are proposing a revision to a current project, R01DK119282 entitled, “Mobile Phone Support for Adults and Support Persons to Live Well with Diabetes.” The current project includes an randomized controlled trial (RCT) to test the efficacy of the FAMS 2.0 (Family/friend Activation to Motivate Self-Care) intervention among N=334 adults with type 2 diabetes mellitus and a friend or family member who enrolls as a support person. The RCT includes a 9-month intervention period for those so assigned and 6-months of post-intervention follow up for a 15-month study. Recently, our team identified a typology of diabetes-specific family functioning which has important implications for intervention. We identified four conceptually distinct profiles of family functioning with respect to diabetes ("types") using cluster analysis and examined adjusted cross-sectional associations between type and diabetes outcomes. We found the typology was stable across analytic method and type was independently associated with diabetes outcomes, including glycemic control (primary outcome in the FAMS 2.0 RCT), diabetes distress (secondary outcome in the FAMS 2.0 RCT), diabetes self-efficacy and medication adherence (targeted mechanisms of the FAMS 2.0 intervention). The typology is the first ever to capture multiple dimensions of family functioning specific to diabetes self-management, is applicable across modern family structures, and has the potential to lead to breakthroughs in family interventions for adults with diabetes. Diabetes-specific family functioning type at baseline may be a critical and overlooked moderator of family interventions – including the FAMS 2.0 intervention – among adults with diabetes, and tailoring interventions to type may maximize effects. However, our prior typology study was conducted in a sample that was 75% White and used cross-sectional data. Therefore, we propose to expand the aims of the current R01 by conducting secondary data analysis and adding an exit interview for participants assigned to intervention. The aims of the current project will be unchanged and FAMS 2.0 will not be tailored to type in this RCT. For Aim 1 we will use data collected during the RCT to determine if the typology is replicated in a more diverse sample, examine type stability over time, and examine predictive validity of type for diabetes outcomes over time. For Aim 2, we will use mixed-methods to learn how engagement with and efficacy of the FAMS 2.0 intervention varies by type of diabetes-specific family functioning. Upon completion of these aims we will know how to identify persons with diabetes most likely to benefit from FAMS 2.0 to inform scalability and implementation efforts, and we will have preliminary data for a trial testing the benefit of tailoring interventions to participants' type of diabetes-specific family functioning. This research and future applications of the typology that will result from this research will rapidly advance the science on family interventions for diabetes self-management by supporting novel research questions such as: For whom are family interventions more effective than individual interventions? and How can we predict fit between the patient and intervention content?

项目总结