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Adapting an Adolescent Weight Management Program for a Type 1 Diabetes Population

针对 1 型糖尿病人群调整青少年体重管理计划

基本信息

批准号：
10427858
负责人：
Jennifer Lynn Warnick
金额：
$ 18.97万
依托单位：
MIRIAM HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10427858
关键词：
Address Adolescent Age Attention Award Behavior Behavior Control Behavior Therapy Behavioral Behavioral trial Blood Glucose Body Weight decreased Body mass index Calories Cardiovascular system Caregivers Childhood Clinical Investigator Clinical Research Consumption Dangerous Behavior Data Data Analyses Development Diabetes Mellitus Disease Management Eating Eating Behavior Eating Disorders Ecological momentary assessment Endocrinologist Ensure Event Evidence based intervention Exercise Fright General Population Glycosylated hemoglobin A Goals Grain Guidelines Health Hunger Hypoglycemia Individual Insulin Insulin-Dependent Diabetes Mellitus Intervention Intervention Trial Interview Longevity Measures Mentors Mentorship Mission Modeling Morbidity - disease rate National Institute of Diabetes and Digestive and Kidney Diseases Obesity Outcome Overweight Participant Patient Self-Report Patients Phase Phase Ib Trial Population Populations at Risk Prevalence Randomized Controlled Trials Regulation Research Review Literature Risk Surveys Testing Thinking Time Training Weight Weight Gain Weight maintenance regimen Work Youth acceptability and feasibility adolescent health age group base behavior test behavioral health cardiometabolic risk cardiovascular health cardiovascular risk factor career comorbidity comparative design diet and exercise disorder prevention efficacy testing efficacy trial evidence base experience high risk improved interest medical appointment mortality risk novel obesity in children pilot test post intervention prevent primary outcome programs public health intervention purge secondary outcome sex skills therapy development trial comparing trial design usual care arm

项目摘要

PROJECT ABSTRACT Comorbid overweight/obesity (BMI>85th percentile for sex and age) was rare in youth with type 1 diabetes mellitus (T1DM) prior to the 1990s, but the prevalence now exceeds that of youth in the general population. Behavioral weight management interventions are evidence-based, first-line treatments for pediatric obesity. Yet, there are unique challenges of T1DM that require thoughtful adaptations to these interventions. Examples include reduced exercise and excess calorie consumption due to hypoglycemia. Adolescents with T1DM and comorbid overweight/obesity are also at high risk of developing disordered eating behaviors. There is a critical need for behavioral weight management interventions that address barriers specific to T1DM and incorporate attention to eating disorder prevention in this at-risk population. The objective of this K23 project is to adapt the primary mentor’s (Dr. Elissa Jelalian) established 16-week adolescent weight management intervention for a T1DM population. Using the Obesity-Related Behavioral Intervention Trials (ORBIT) model, a framework for intervention development, this project will design, refine, and test an adapted behavioral weight management intervention for adolescents with comorbid T1DM and overweight/obesity using two related yet distinct studies. Study 1 will ensure feasibility (i.e., participant attendance) and acceptability of intervention materials by adolescents with comorbid T1DM and overweight/obesity using an open-trial design with 2-3 small groups (n=5 adolescents/group). Participants will complete validated measures of acceptability after each weekly session and an exit survey post-intervention. The Candidate will iteratively refine the intervention based upon Study 1 results. Study 2 will compare the adapted weight management intervention to a usual care control group using a pilot randomized controlled trial design (n=50 total adolescents) to verify that the adapted intervention reduces participant BMI and increases the percent time spent in the target blood glucose range (70-180mg/dL; primary outcomes). Participants in Study 2 will complete ecological momentary assessments (EMA) at baseline and 16-weeks to determine events of maladaptive eating and weight control behaviors over time (secondary outcomes). Exploratory analyses will evaluate correlates of these maladaptive eating and weight control behaviors in real-world settings. This K23 project builds upon the Candidate’s prior work in pediatric obesity and T1DM. The highly qualified and expert mentorship team will provide support and oversight, allowing the Candidate to acquire the necessary skills to launch an independent research career aimed at improving weight management for adolescents with comorbid T1DM and overweight/obesity. Results will provide data for a subsequent application to conduct a fully powered randomized controlled trial to test the efficacy of the adapted weight management intervention. The proposed project aligns with the NIDDK’s mission to mitigate diabetes-related cardiovascular events and has the potential to be an important public health intervention to improve the health of adolescents with T1DM and overweight/obesity.

项目摘要