Improving Mealtime Functioning in Families of Young Children with Type 1 Diabetes

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DESCRIPTION (provided by applicant): The K23 candidate is a pediatric psychologist and junior faculty member in the Department of Pediatrics at the University of Michigan. She recently completed an NRSA fellowship in the study of mealtime behaviors in young children with type 1 diabetes (T1DM), and now requires a final program of highly specialized didactics and advanced mentorship in order to become a leading federally-funded clinical investigator in pediatric diabetes. The candidate's long term career goal is to pioneer the development of effective new behavioral interventions to improve parent-child functioning, quality of life, and health outcomes in young children with T1DM. Her immediate career development goals are to: 1) complete her training in clinical research, 2) deepen her expertise on T1DM in young children and the measurement of related health outcomes, and 3) become a leading federally-funded clinical investigator in pediatric diabetes. The candidate thus proposes a five-year program of intensive mentorship and training by nationally renowned clinical investigators; structured didactics covering the development of manualized clinical interventions in behavioral medicine, the design of randomized clinical trials, grant writing skills, and research ethics; and a two-Study research plan. Study 1 will use a prospective behavioral observation study of 32 children and their families to test a set of hypotheses surrounding parent-child mealtime behaviors, parent psychological factors, and children's blood glucose control. During Study 2, the results of Study 1 will drive the specification of a new behavioral intervention to improve mealtime functioning. After an iterative program of developmental trials and expert review, the candidate will estimate the blood glucose impact of the resulting standardized intervention through a pilot study of 10 children and their families. To summarize, the proposed program of activities are the final steps needed for the candidate to develop into a fully independent patient-oriented investigator in pediatric diabetes. The candidate's success potentially has major public health impact, because T1DM is a common disease among young children, and the design of effective interventions could improve functioning and health outcomes for approximately 22,000 US children and families.