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

DiaBetter Together：一项基于优势的同伴导师计划，旨在支持患有 1 型糖尿病的年轻人从儿科到成人护理的过渡

• 批准号: 10502760
• 负责人: Marisa Ellen Hilliard
• 金额: $ 12.94万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10502760
• 关键词: Accountability; Adherence; Adolescence; Adult; Age; Age-Years; Appointment; Behavioral; Biological Markers; Caring; Childhood; Clinic; Clinical; Cognitive; Dangerousness; Data; Development; Diabetes Mellitus; Distress; Evidence based program; Family; Family Relationship; Feeling; Friends; Glycosylated hemoglobin A; Goals; Health; Healthcare; Healthcare Systems; Hospitalization; Infrastructure; Insulin-Dependent Diabetes Mellitus; Interpersonal Relations; Intervention; Logistics; Mediating; Mediation; Methods; Modeling; Occupational; Outcome; Parents; Participant; Patient-Focused Outcomes; Patients; Pediatric Hospitals; Pediatrics; Personal Satisfaction; Persons; Problem Solving; Provider; Psychological reinforcement; Quality of life; Questionnaires; Randomized; Readiness; Recommendation; Regimen; Reporting; Research; Resources; Risk; Role; Schools; Self Care; Self Management; Social Workers; Social support; Source; Supervision; Support System; Techniques; Testing; Texas; Time; Time Management; Training; Uncertainty; Visit; Work; arm; base; care providers; college; depressive symptoms; diabetes distress; diabetes management; diabetes self-management; emerging adult; experience; follow-up; glycemic control; group intervention; health care settings; high risk; improved; intervention participants; medical appointment; novel; novel strategies; peer; peer coaching; peer support; prevent; primary outcome; programs; psychoeducational; psychosocial wellbeing; resilience; role model; secondary outcome; skills; skills training; social; social model; social situation; stress management; treatment adherence; treatment as usual; young adult

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.

项目摘要/摘要 1型糖尿病(T1D)的管理对年轻人来说是具有挑战性的，他们承担着自我管理的责任 管理并将T1D护理从儿科医疗系统转移到成人医疗系统，因为他们还管理典型的 发展需求(例如，社会、经济、工作/学校、居住)。许多年轻人已经延长了 (&gt；6个月)在成人护理之前的差距，这增加了他们健康状况不佳的风险，并且 严重的健康并发症。几乎没有循证计划来支持年轻的T1D患者 儿童护理和成人护理之间的过渡期。适合发展的新方法有 需要帮助年轻人应对患有T1D的挑战，并及时完成向 成人护理。这项拟议研究的目标是评估一种针对患有T1D的年轻人的新干预措施 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后T1D护理的相关信息。在世界各地 当他们离开儿科T1D护理时，患有T1D的年轻人将与训练有素的“同伴导师”配对，并 经验丰富、年龄稍大的患有T1D的年轻人，他们将亲自与他们会面，并经常(每周， 然后每月)联系12个月。在接触期间，同伴导师将使用基于优势的 心理教育策略，教授和示范解决问题和管理压力的技能，鼓励 年轻人向他们现有的社会支持网络(例如，家人、朋友)寻求支持，并确定 糖尿病相关支持的新来源，帮助年轻人在非常短的时间内优先考虑T1D自我护理 要求苛刻的青壮年时期，分享他/她的过渡经验和成功导航的策略 成人保健系统，并为第一次成人护理访问做好准备。同伴导师将起到积极的作用 关于过渡的帮助、鼓励和责任的模式和来源，目标是减少 与世隔绝，促进自我管理，防止护理方面的差距。我们将用150来测试这种干预 年轻人被随机分配到干预或常规护理中。我们的主要目标是评估 干预对重要的T1D结局的影响，如血糖控制、成人护理时间、治疗 坚持性和社会心理健康。诊所预约信息、问卷、依从性数据和 血糖控制生物标志物将在基线以及6个月和12个月后收集。这样做的最终目的是 研究旨在验证可促进T1D自我管理和护理转移的支持性干预 在困难的青壮年，并促进最佳的T1D健康结果。