DiaBetter Together: A Strengths-Based Peer Mentor Program to Support Young Adults with Type 1 Diabetes During the Transition from Pediatrics to Adult Care

项目概要/摘要 1型糖尿病（T1 D）的管理对年轻人来说是一个挑战，他们承担着自我保护的责任。 管理并将T1 D护理从儿科转移到成人医疗保健系统，因为他们还管理典型的 发展需求（例如，社会、金融、工作/学校、住宅）。许多年轻人已经扩展了 （>6个月）的差距，这增加了他们健康状况不佳的风险， 严重的健康并发症。有一些基于证据的计划，以支持年轻的成年人与T1 D期间， 儿科和成人护理之间的过渡期。新颖的、适合发展的方法是 需要帮助年轻人应对T1 D生活的挑战，并及时完成过渡， 成人护理这项拟议研究的目的是评估一种针对年轻T1 D患者的新干预措施， 最大化糖尿病相关的社会支持。拟议的过渡干预建立在年轻人的社会 支持网络，并为他们提供有关成年T1 D护理的相关信息。各地 当他们离开儿科T1 D护理时，患有T1 D的年轻成年人将与训练有素的“同伴导师”配对， 有经验的，稍微年长的T1 D年轻人，他们将亲自与他们会面，并经常（每周， 然后每月一次）联系12个月。在接触过程中，同伴导师将使用基于优势的 心理教育策略，以教授和示范解决问题和压力管理技能，鼓励 年轻人从他们现有的社会支持网络寻求支持（例如，家人、朋友）并确定 糖尿病相关支持的新来源，帮助年轻人优先考虑T1 D自我护理， 要求高的年轻人时期，分享他/她的过渡经验和成功导航的策略 成人保健系统，并为第一次成人保健访问做准备。同伴导师将发挥积极作用 围绕过渡提供帮助、鼓励和问责的模式和来源，目标是减少 隔离，促进自我管理，防止护理差距。我们将用150个 年轻人被随机分配到干预或常规护理。我们的主要目标是评估 干预对重要T1 D结局的影响，如血糖控制、至成人护理的时间、治疗 坚持和心理健康。诊所预约信息、调查问卷、依从性数据，以及 将在基线和6个月和12个月后收集血糖控制生物标志物。这个项目的最终目标 研究的目的是验证一种支持性干预措施，可以促进T1 D自我管理和护理转移 在困难的年轻成年人时期，促进最佳的T1 D健康结果。

PROJECT SUMMARY/ABSTRACT Type 1 diabetes (T1D) management is challenging for young adults, who assume responsibility for self- management and transfer T1D care from the pediatric to adult healthcare system as they also manage typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended (>6 months) gaps before following up in adult care, which increase their risk for poor health outcomes and serious health complications. There are few evidence-based programs to support young adults with T1D during the transfer period between pediatric and adult care. Novel, developmentally appropriate approaches are needed to help young adults negotiate the challenges of living with T1D and complete a timely transition to adult care. The goal of the proposed study is to evaluate a new intervention for young adults with T1D that maximizes diabetes-related social support. The proposed transition intervention builds on young adults' social support network and provides them access to relevant information about T1D care in adulthood. Around the time they leave pediatric T1D care, young adults with T1D will be paired with a trained “Peer Mentor,” an experienced, slightly older young adult with T1D, who will meet with them in-person and have frequent (weekly, then monthly) contact for 12 months. During the contacts, the Peer Mentor will use strengths-based psychoeducational strategies to teach and model problem-solving and stress-management skills, encourage the young adult to seek support from their existing social support network (e.g., family, friends) and identify new sources of diabetes-related support, help the young adult prioritize T1D self-care during the very demanding young adult period, share his/her transition experiences and strategies for successfully navigating the adult healthcare system, and prepare for the first adult care visit. The Peer Mentor will be a positive role model and source of help, encouragement, and accountability around transition, with the goal of reducing isolation, promoting self-management, and preventing gaps in care. We will test this intervention with 150 young adults randomly assigned to the intervention or usual care. Our main goal is to evaluate the intervention's impact on important T1D outcomes, such as glycemic control, time to adult care, treatment adherence, and psychosocial well-being. Clinic appointment information, questionnaires, adherence data, and glycemic control biomarkers will be collected at baseline and 6 and 12 months later. The ultimate goal of this research is to validate a supportive intervention that can facilitate T1D self-management and transfer of care during the difficult young adult years and promote optimal T1D health outcomes.