Family Matters: Optimizing Family-Based Interventions for Adolescents with Type 1 Diabetes

项目摘要/摘要 患有1型糖尿病(T1D)的青少年通常会经历血糖控制恶化，这种恶化可能会持续到 成人期。尽管以家庭为基础的干预措施得到了经验支持，以抵消这种青少年风险，例如 行为健康服务很少包括在糖尿病护理中。这项K23提案旨在弥合这一差距 在研究和实践之间，通过优化基于家庭的方案，提供最有效、最明智、 并简化了对青少年T1D的干预。拟议的研究旨在1)试点和 评估特定的以家庭为基础的干预组成部分，以及2)确定解释和影响的因素 干预效果。首先，候选人将使用定性方法试行3个干预模块以进行评估 可行性和可接受性。每个模块对应于3个关键家庭过程之一：父母 监测、父母参与和亲子冲突，其中每一个都与经验相关 青少年糖尿病管理和血糖控制是常见的基于家庭的干预目标。 接下来，候选人将对干预模块进行实验测试，以评估其相对 效果以及对青少年结果的综合影响。最后，候选人将进行高级 统计分析，以验证特定的家庭过程(包括一般和特定于糖尿病的) 解释(调解)项目效果以及影响(适度)干预的背景因素 效果。这一建议将产生优化的以家庭为基础的干预措施，并提供关键的经验 关于家庭功能、心理健康和血糖控制之间的因果关系的信息 患有T1D的青少年。K23奖项提供必要的培训、指导、受保护的时间和资源 完成拟议的研究并支持王博士成为独立研究人员的进展 儿科糖尿病科学家。

Project Summary/Abstract Adolescents with type 1 diabetes (T1D) often experience deteriorations in glycemic control that can persist into adulthood. Although family-based interventions are empirically supported to offset this adolescent risk, such behavioral health services are rarely included in diabetes care. This K23 proposal seeks to bridge this gap between research and practice by optimizing family-based programs to provide the most efficacious, judicious, and streamlined intervention possible to adolescents with T1D. The proposed study aims to 1) pilot and evaluate specific family-based intervention components, and 2) identify the factors that explain and influence intervention effects. First, the candidate will use qualitative methods to pilot 3 intervention modules to assess feasibility and acceptability. Each module corresponds to one of 3 critical family processes: parental monitoring, parental involvement, and parent-adolescent conflict, each of which are empirically linked to adolescent diabetes management and glycemic control and are common family-based intervention targets. Next, the candidate will conduct an experimental trial of the intervention modules to evaluate their relative efficacy as well as combined impact on adolescent outcomes. Finally, the candidate will conduct advanced statistical analyses to verify the specific family processes (including both general and diabetes-specific) that explain (mediate) program effects as well as the contextual factors that influence (moderate) intervention effects. This proposal will yield an optimized family-based intervention as well as provide critical empirical information about the causal pathways between family functioning, mental health, and glycemic control among adolescents with T1D. The K23 award offers the training, mentorship, protected time, and resources necessary to complete the proposed study and support Dr. Wong’s progress toward becoming an independent research scientist in pediatric diabetes.