Positive Psychology to Promote Adherence in Adolescents with Type 1 Diabetes

描述（由申请人提供）：青少年1型糖尿病患者的依从性问题很常见-发生率高达93% -并具有严重的健康后果，包括血糖控制欠佳和后期并发症风险。然而，以前的干预措施，以提高青少年1型糖尿病患者的依从性只显示出中度至中度的效果，许多都是时间密集型和昂贵的。因此，需要新的干预措施来改善青少年1型糖尿病患者的依从性。增加积极影响（例如，感觉快乐、愉快、自豪）已被证明可促进成年人群对治疗建议的依从性。我们建议开发、修订和试点测试一种针对1型糖尿病青少年的积极心理干预，旨在增加坚持的动力。这一创新的干预措施将通过感恩、自我肯定、小礼物和父母肯定等量身定制的练习，在青少年（13-17岁）中产生积极的影响，以促进遵守。具体来说，我们的目标是增加血糖监测的频率，这是依从性的最佳指标之一，与血糖控制密切相关。我们还将探索技术的使用，通过开发和比较电话管理与自动短信版本的干预，以确定哪种交付模式对青少年更有吸引力和更方便。该研究将由一个多学科团队进行，由儿科心理学家Sarah Jaser博士和两名合作者Robin Whittemore博士，APRN护士研究员和儿科内分泌学家Stuart Weinzimer博士组成。我们相信，这种低成本的积极心理干预有可能增加青少年进行血糖监测的动力，而不会增加治疗管理的负担。拟议研究的结果将为该干预措施的大规模随机临床试验提供基础。

DESCRIPTION (provided by applicant): Problems with adherence in adolescents with type 1 diabetes are common - occurring at rates as high as 93% - and have serious health consequences, including suboptimal glycemic control and risk for later complications. Yet, previous interventions to improve adherence in adolescents with type 1 diabetes have only shown modest to moderate effects, and many have been time-intensive and expensive. Thus, there is a need for novel interventions to improve adherence in adolescents with type 1 diabetes. Increasing positive affect (e.g., feeling happy, cheerful, proud) has been shown to promote adherence to treatment recommendations in adult populations. We propose to develop, revise, and pilot test a positive psychology intervention for adolescents with type 1 diabetes aimed at increasing motivation for adherence. This innovative intervention would induce positive affect in adolescents (age 13-17) through tailored exercises in gratitude, self-affirmation, small gifts, and parent affirmations to promote adherence. Specifically, we aim to increase the frequency of blood glucose monitoring, which is one of the best indicators of adherence and is strongly linked to glycemic control. We will also explore the use of technology, by developing and comparing telephone-administered vs. automated text- messaging versions of the intervention, to determine which mode of delivery is more appealing and convenient for adolescents. The study will be conducted by a multidisciplinary team, consisting of Sarah Jaser, PhD, a pediatric psychologist, and two collaborators, Robin Whittemore, PhD, APRN, a nurse researcher, and Stuart Weinzimer, MD, a pediatric endocrinologist. We believe that this low-cost positive psychology intervention has the potential to increase adolescents' motivation for performing blood glucose monitoring without adding to the burden of treatment management. Results from the proposed study will provide the basis for a large scale randomized clinical trial of the intervention.