Healthy Eating,Physical Activity, & Glycemic Control in Young Children with T1D

 描述（由申请人提供）：1型糖尿病（T1 D）在幼儿（年龄<5岁）中的发病率正在上升。管理这种疾病的日常责任负担主要由儿童的父母/照顾者福尔斯承担，以检查血糖、施用胰岛素、监测饮食和体力活动，以实现严格的血糖控制。这些任务由于儿童不可预测的行为和不稳定的胰岛素水平以及随之而来的父母压力而变得复杂。因此，我们开发新的行为干预措施以更好地解决儿童糖尿病患者的血糖控制问题，这对儿童糖尿病领域至关重要。我们将接受这一挑战，并开发和试点测试一种创新的治疗方案，用于幼儿T1 D的父母管理。我们建议通过使用经过验证的策略，重点促进健康饮食和参与体育活动。提供“第一类培训”（T. O.T.）干预预计将通过电话和短信、诊所内和非专业家长顾问进行。这项工作将分两个阶段进行。在第一阶段，被诊断患有T1 D的幼儿的主要照顾者将接受我们的T. O.T. s草案，并在干预后评估行为和血糖控制指数。参与者将接受形成性访谈，以提供有关他们在该计划中的经验的丰富的背景数据。第一阶段的研究结果将有助于推动第二阶段的干预改进和额外的beta测试：参与者将被随机分配到T. O.T. s（治疗）或常规护理（对照）条件。干预内容包括：针对改善饮食和体育活动行为的育儿策略，以及T1 D管理支持。这些将通过多种方式和变革推动者提供。将在基线和6个月后进行生物医学和心理社会测量（包括HbA 1c、体力活动、营养、进餐时间行为、儿科养育压力、生活质量）。这项工作的结果将最终导致一种临床行为治疗，可以改善幼儿的T1 D血糖控制，并可以考虑进行进一步的测试和临床转化。

 DESCRIPTION (provided by applicant): The incidence of type 1 diabetes (T1D) in young children (age <5 years) is rising. The daily burden of responsibility for managing this disease largely falls to children's parents/caregivers to check blood sugar, administer insulin, and monitor diet and physical activity to achieve tight glycemic control. These tasks are complicated by children's unpredictable behaviors and erratic insulin levels, and ensuing parental stress. Thus, it is critical for the field of pediatric diabetes that we develop new behavioral interventios to better address glycemic control in this population. We will undertake this challenge, and develop and pilot test an innovative treatment program for parental management of T1D in young children. We propose to focus on promoting healthy eating and engagement in physical activity through the use of well-proven strategies with the general population. Delivery of the "Type One Training" (T.O.T.) intervention is expected to take place via phone and text message, in-clinic, and with lay parent consultants. The work will be carried-out in two phases. In Phase 1, primary caregivers of young children diagnosed with T1D will receive our draft version of T.O.T.s and be assessed post-intervention on indices of behavior and glycemic control. Participants will undergo formative interviews to provide rich, contextual data about thei experience in the program. Phase 1 findings will help drive intervention refinement and additional beta testing for Phase 2: where participants will be randomized to either a T.O.T.s (treatment) or usual care (control) condition. Intervention components are expected to include: parenting strategies specific to improving eating and physical activity behaviors, and T1D management support. These will be delivered across multiple modalities and change agents. Biomedical and psychosocial measurements (including HbA1c, physical activity, nutrition, mealtime behavior, pediatric parenting stress, quality of life) will occur at baseline and up to 6-months afterward. The results of this work will ultimately lead to a clinical behavioral treatment that may improve young children's T1D glycemic control and can be considered for further testing and clinical translation.