Developing a diabetes self-management mHealth simulation platform for youth

项目总结 对于美国150万患有1型糖尿病(T1D)的人来说，保持 接近正常的血糖控制，通常通过糖化血红蛋白(A1c)来衡量，以防止微血管 大血管并发症也是家常便饭。尽管最近取得了进步，并增加了对 管理糖尿病的技术(即胰岛素泵、持续血糖监测(CGM)、混合闭环 (HCL系统)，70%的1型糖尿病(T1D)患者没有达到他们的A1c目标。青少年的饮食习惯 比儿童和成年人更糟糕，目前只有17%的人实现了目标。胰岛素泵疗法是一种更 生理形式的胰岛素输送比每天多次注射更多，然而这些复杂的机器严重依赖于 个人利用和自我管理行为。在这个以患者为导向的指导研究生涯中 发展奖(K23)我们提出了三项截然不同但相互补充的研究。首先，我们将考察小说 通过对青少年和青少年糖尿病设备的二次分析了解青少年和青少年糖尿病患者的自我管理 大数据集结合了糖尿病设备的自我管理、使用率和来自年轻人的血糖数据 糖尿病装置(如胰岛素泵、CGM、HCL)。其次，我们将扩展功能并测试其有效性 针对10-18岁青少年(10-18岁)的现有mHealth糖尿病教育模拟平台(A1Control) T1D使用参与式设计技术，包括联合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，以评估移动健康的可行性、持续参与度和影响 对T1D青少年(10-18岁)进行干预。这项拟议的培训奖与NINR的一致 支持模拟或改进对自我管理行为的理解的研究以及 在推进数据分析以改善健康的技术方面保持横向一致。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)增进知识和 参与性设计方法的技能；以及，(3)获得临床试验干预开发和 测试。职业目标将通过正式教学和非正式培训相结合的方式实现； 参加国家会议和讲习班；在#年的指导下进行实践研究培训 在以患者为中心的技术开发领域(Mion和Happ)拥有一支成就卓著的科学家团队， 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来自护理的跨学科团队， 内分泌学、工程学和公共卫生。从这份职业中获得的技能、经验和培训 发展奖将为成功职业生涯的候选人定位为一名专注于 论慢性病自我管理与技术利用的科学与发展 组织未来的大规模试验，旨在促进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.