Mindfulness-Based Stress Reduction in Adolescents with Type 1 Diabetes

基于正念的 1 型糖尿病青少年减压

• 批准号: 10552006
• 负责人: Kaitlyn Rechenberg
• 金额: $ 13.7万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-18 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10552006
• 关键词: 18 year old; 19 year old; Acute; Address; Adolescent; Adult; Affect; Anxiety; Behavior Therapy; Cardiovascular system; Cellular Phone; Child; Childhood; Chronic; Clinical; Clinical Investigator; Complications of Diabetes Mellitus; Conscious; Consumption; Continuous Glucose Monitor; Development; Diabetes Mellitus; Diabetic Ketoacidosis; Disease; Disease Management; Disease Outcome; Endocrinologist; Endocrinology; Evidence based intervention; Evidence based treatment; Funding; Future; Goals; Health; High Prevalence; Hour; Hypoglycemia; Incidence; Insulin-Dependent Diabetes Mellitus; International; Intervention; Interview; K-Series Research Career Programs; Kidney; Knowledge; Knowledge acquisition; Learning; Life Style; Mental Depression; Mental Health; Mentors; Methods; Mobile Health Application; Nature; Neuropathy; Nurse Practitioners; Nurses; Outcome; Peer Review; Perception; Physiological; Population; Process; Psychologist; Publications; Quality of life; Randomized, Controlled Trials; Research; Risk; Risk Reduction; Science; Self Management; Sleeplessness; Social Workers; Symptoms; Testing; Time; Training; Treatment Protocols; United States; Work; acceptability and feasibility; anxiety management; anxiety reduction; anxiety symptoms; associated symptom; behavior test; brief intervention; career; clinical practice; clinically significant; cost; data integration; design; effective intervention; evidence base; experience; feasibility testing; glycemic control; high risk population; improved; innovation; mHealth; mindfulness intervention; mindfulness-based stress reduction; prevent; programs; prototype; psychosocial; psychosocial development; skills; sustainability framework; therapy development

PROJECT SUMMARY Type 1 diabetes (T1D) is one of the most prevalent chronic conditions in adolescents in the United States, affecting approximately 1 in 400 adolescents by 18 years of age. Adolescents with T1D are at risk for acute and long-term complications, including diabetic ketoacidosis, severe hypoglycemia, and cardiovascular, renal, and neuropathic disease. Maintaining adequate glycemic control reduces the risk of these complications. Anxiety symptoms are prevalent in adolescents with T1D, occurring at approximately 2 to 3 times the rate of the general adolescent population. Anxiety symptoms are associated with out-of-range glycemic control, poor quality of life (QOL), and poor self-management. Targeted interventions to reduce anxiety symptoms will contribute to improved QOL and improved self-management of T1D and thus improved disease outcomes. Despite the high prevalence of anxiety symptoms and strong associations with diabetes-related complications, few evidence-based interventions have been adapted for this high-risk population. This proposal uses a systematic and iterative approach to adapt an evidence-based intervention for anxiety symptoms, mindfulness- based stress reduction (MBSR), specifically to meet the developmental and lifestyle needs of this population. My goal in seeking a Mentored Research Career Development Award is to acquire the knowledge, skills, and research experience necessary to become an independent clinical investigator focused on developing, implementing, and testing behavioral interventions and improving disease outcomes in adolescents with Type 1 diabetes (T1D). This proposal constructs and tests the feasibility and acceptability of an adapted MBSR mHealth application for adolescents with T1D. The specific aims of this mixed methods proposal are to: 1. Analyze qualitative interviews with 20 adolescents with T1D and conduct interviews with 10 key stakeholders (pediatric endocrinologist, pediatric endocrinology (PE) nurse practitioner, PE nurse, PE psychologist, and PE social worker) to ascertain challenges, needs, and perceptions related to anxiety management, mindfulness- based interventions, and mHealth application features.; 2. Generate an mHealth application prototype that integrates data obtained from Aim 1 to adapt MBSR specifically for adolescents with T1D; 3a. Evaluate the MBSR mHealth application prototype for engagement, feasibility, and acceptability among 40 adolescents with T1D; and 3b. Explore preliminary efficacy of the adapted MBSR mHealth application prototype on anxiety symptoms, QOL, self-management, and glycemic control in 40 adolescents with T1D. Proposed career and learning objectives are to: 1. Develop comprehensive knowledge of mHealth intervention development and implementation.; 2. Acquire intensive training in the delivery of MBSR.; and 3. Disseminate findings through national and international presentations, and peer-reviewed publications. Long-term career goal: Build a robust program of externally-funded research to develop and disseminate interventions that are sustainable and actively utilized in clinical practice.

项目总结 1型糖尿病(T1D)是美国青少年中最常见的慢性病之一， 到18岁时，大约每400名青少年中就有1人受到影响。患有T1D的青少年有患急性胰腺炎的风险 以及长期并发症，包括糖尿病酮症酸中毒、严重低血糖以及心血管、肾脏、 和神经性疾病。维持适当的血糖控制可降低这些并发症的风险。 焦虑症状在患有T1D的青少年中很普遍，发生率约为T1D的2-3倍 一般的青少年人口。焦虑症状与血糖控制不佳有关， 生活质量(QOL)和自我管理能力差。有针对性的干预措施将减少焦虑症状 有助于改善生活质量和改善T1D的自我管理，从而改善疾病结局。 尽管焦虑症状的发生率很高，而且与糖尿病相关的并发症有很强的相关性， 针对这一高危人群的循证干预措施很少。此提案使用一个 系统和迭代的方法，以适应基于证据的干预，焦虑症状，正念- 基于压力减轻(MBSR)，特别是为了满足这一人群的发展和生活方式需求。 我寻求导师研究职业发展奖的目标是获得知识、技能和 成为一名独立的临床调查员所需的研究经验，专注于开发、 实施和测试行为干预措施，改善青少年类型性疾病的结局 糖尿病(T1D)1例。该方案构建并测试了修改后的MBSR的可行性和可接受性 针对患有T1D的青少年的mHealth应用程序。这一混合方法建议的具体目的是：1. 分析对20名患有T1D的青少年的定性访谈，并与10名关键利益相关者进行访谈 (儿科内分泌学家、儿科内分泌学(PE)护士实践者、PE护士、PE心理学家和PE 社会工作者)以确定与焦虑管理、正念相关的挑战、需求和看法- 基于干预措施和mHealth应用程序特征；2.生成mHealth应用程序原型，该原型 整合从AIM 1获得的数据，以使MBSR特别适用于患有T1D；3a的青少年。评估 MBSR mHealth应用原型在40名青少年中的参与度、可行性和可接受性 T1d和3b。探索改编的MBSR mHealth应用原型对焦虑的初步疗效 40例T1D青少年的症状、生活质量、自我管理和血糖控制。 建议的职业和学习目标是：1.全面了解移动健康干预 制定和实施；2.获得关于交付MBSR的强化培训；3.传播 通过国家和国际介绍以及同行评议的出版物发布调查结果。 长期职业目标：建立一个强有力的外部资助研究项目，以开发和传播 可持续并积极用于临床实践的干预措施。