Reducing Disparities in Pediatric Diabetes: Building the Evidence Base to Inform Effective Diabetes Technology Interventions in Underrepresented Minorities

减少儿童糖尿病的差异：建立证据基础，为代表性不足的少数群体提供有效的糖尿病技术干预措施

• 批准号: 10517085
• 负责人: Ananta Addala
• 金额: $ 19.41万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-08 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10517085
• 关键词: Address; Attitude; Award; Caring; Childhood; Childhood diabetes; Clinical; Clinical Trials; Communities; Data; Databases; Development; Diabetes Mellitus; Disadvantaged; Endocrinology; Epidemiology; Etiology; Family; Focus Groups; Foundations; Future; Goals; Insulin-Dependent Diabetes Mellitus; Intervention; Knowledge; Literature; Mentors; Mentorship; Methods; Outcome; Phase; Physicians; Provider; Proxy; Quality of life; Recommendation; Reporting; Research; Research Design; Research Methodology; Research Personnel; Scientist; Socioeconomic Status; Structure; Surveys; Technology; Testing; Time; Training; Treatment Efficacy; Underrepresented Minority; Underrepresented Populations; Youth; acceptability and feasibility; behavioral health; brief intervention; career; community barrier; design; diabetes management; disparity reduction; efficacy evaluation; ethnic minority population; evidence base; glucose monitor; health disparity; implicit bias; improved; improved outcome; innovation; interest; intervention delivery; low socioeconomic status; multidisciplinary; perceived discrimination; phase 2 testing; practical application; promoter; provider-level barriers; public health insurance; racial and ethnic; skills; social; socioeconomics; statistics; system-level barriers; therapy design; therapy development; uptake

PROJECT SUMMARY/ABSTRACT As diabetes technologies have become more innovative and effective in the management of pediatric type 1 diabetes (T1D), research and usage has preferentially increased only in those of higher socioeconomic status (SES). Studies have consistently demonstrated 50% lower rates of diabetes technology use in youth of lower SES. Although diabetes technology has the potential to reduce disparities in pediatric T1D outcomes, inequitable access has resulted in worsening of T1D outcomes for low SES youth. This proposal aims to build an evidence base for data-driven interventions designed to reduce disparities in diabetes innovations by addressing barriers and supporting promoters of diabetes technology use. Ananta Addala, D.O., M.P.H, is a physician scientist committed to a career as an independent investigator addressing disparities in T1D management and outcomes. Dr. Addala’s longstanding research and clinical interests are to promote equitable care for youth with T1D. As a physician with a background in pediatric endocrinology, epidemiology, and behavioral health, Dr. Addala is uniquely qualified to address the drivers of inequities in diverse youth with T1D. Dr. Addala has enlisted a multi-disciplinary mentorship team comprised of experts in the fields of pediatric T1D, health disparities, statistics, and mixed method study design to successfully execute this proposal and launch an independent research career in pediatric T1D disparities. The overall objective of this proposal is to discover drivers of disparities in diabetes technology use in youth with T1D and public insurance and develop a brief intervention, as a means to understand and address pediatric T1D disparities. This will be accomplished through two aims. In aim 1, focusing on the family, Dr. Addala will construct an evidence base of barriers and promoters to diabetes technology use in youth with public insurance in order to formulate and test a brief pilot intervention aimed at increasing uptake. In aim 2, this time focusing on the providers, Dr. Addala will construct the evidence base on barriers and promoters to recommending diabetes technology to youth with public insurance in order to formulate and test a brief pilot intervention to increase provider recommendation of diabetes technology. Taken together, findings from Aims 1 and 2 will result in the development of an intervention aimed at increasing diabetes technology uptake and access in youth from low socioeconomic and racial/ethnic minority groups, thereby improving T1D outcomes. Dr. Addala will use the K23 mentored award to execute an in-depth training plan which includes formal coursework and structured mentorship by her mentors to advance her understanding of mixed methods research, intervention development, and expertise on disparities. This proposal is foundational to a future independent clinical trial to evaluate the efficacy of the interventions developed on promoters and barriers of diabetes technology use in youth with T1D and public insurance.

项目总结/摘要 随着糖尿病技术在儿科类型的管理中变得更加创新和有效， 1型糖尿病（T1 D）的研究和使用仅在社会经济地位较高的人群中优先增加 地位（SES）。研究一致表明，年轻人使用糖尿病技术的比例降低了50%， 低SES。虽然糖尿病技术有可能减少儿童T1 D结局的差异， 不公平的获取导致低社会经济地位青年的T1 D结果恶化。该提案旨在建立 数据驱动干预措施的证据基础，旨在通过以下方式减少糖尿病创新的差异： 消除障碍，支持糖尿病技术的推广使用。 Ananta Addala，D.O.，M.P.H.是一位致力于独立调查的医生科学家 解决T1 D管理和结果方面的差异。Addala博士长期的研究和临床 我们的目标是促进对T1 D青少年的公平照顾。作为一名具有儿科背景的医生 内分泌学，流行病学和行为健康，Addala博士是唯一有资格解决的驱动因素， 不同类型T1 D青年的不平等。Addala博士招募了一个多学科的导师团队， 儿科T1 D、健康差异、统计学和混合方法研究设计领域的专家， 成功地执行这一建议，并在儿科T1 D差异方面开展独立的研究事业。 该提案的总体目标是发现青年糖尿病技术使用差异的驱动因素 与T1 D和公共保险，并制定一个简短的干预，作为一种手段，以了解和解决 儿科T1 D差异。这将通过两个目标来实现。在目标1中，侧重于家庭， Addala将建立一个关于青年人使用糖尿病技术的障碍和促进因素的证据库， 公共保险，以制定和测试一个简短的试点干预措施，旨在增加吸收。在目标2中， 这一次重点放在供应商，Addala博士将构建障碍和促进者的证据基础， 向有公共保险的年轻人推荐糖尿病技术，以制定和测试一个简短的试点项目， 干预措施，以增加提供者对糖尿病技术的推荐。 目标1和目标2的调查结果合在一起，将导致制定一项干预措施， 增加社会经济地位低下和种族/族裔少数的青年对糖尿病技术的吸收和获得 从而改善T1 D结果。Addala博士将利用K23指导奖执行一项深入的 培训计划，其中包括正式的课程和结构化的指导，由她的导师，以提高她 了解混合方法研究，干预措施的发展，以及对差异的专业知识。这项建议 是未来独立临床试验的基础，以评估开发的干预措施的有效性。 糖尿病技术在T1 D青年和公共保险中使用的推动者和障碍。