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

健康饮食、体育活动、

• 批准号: 8806637
• 负责人: RANDI STREISAND
• 金额: $ 228.27万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-20 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8806637
• 关键词: 5 year old; Address; Adoption; Affect; Age; Area; Attention; Behavior; Behavior Control; Behavior Therapy; Behavioral; Biological; Blood Glucose; Caregivers; Caring; Child; Childhood; Chronic; Clinic; Clinical; Cognitive; Complications of Diabetes Mellitus; Data; Development; Diabetes Mellitus; Diagnosis; Diet; Diet Monitoring; Disease; Eating; Educational Intervention; Food; General Population; Glycosylated hemoglobin A; Health; Incidence; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; Lead; Life; Literature; Measurement; Measures; Mediating; Methods; Modality; Monitor; Outcome; Parenting behavior; Parents; Participant; Patient Outcomes Assessments; Patients; Persons; Phase; Physical activity; Population; Positioning Attribute; Professional counselor; Provider; Public Health; Quality of life; Randomized; Recommendation; Regulation; Relative (related person); Reliance; Risk; Self Care; Stress; System; Techniques; Telephone; Testing; Text; Time; Training; Translations; Treatment Efficacy; Work; Youth; base; design; diabetes control; diabetes management; efficacy trial; experience; falls; glucose monitor; glycemic control; improved; indexing; innovation; intervention program; member; multidisciplinary; novel; nutrition; post intervention; prevent; programs; psychosocial; public health relevance; randomized trial; standard care; therapy design; tool; treatment as usual; treatment program

 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.

 描述(由申请人提供)：1型糖尿病(T1D)在幼儿(5岁)中的发病率正在上升。管理这种疾病的日常责任主要落在儿童的父母/照顾者身上，他们要检查血糖，注射胰岛素，并监测饮食和体力活动，以实现严格的血糖控制。这些任务由于孩子不可预测的行为和反复无常的胰岛素水平，以及随之而来的父母压力而变得复杂。因此，对于儿童糖尿病领域，我们开发新的行为干预措施以更好地解决这一人群的血糖控制问题是至关重要的。我们将接受这一挑战，并开发和试点一项针对幼儿T1D父母管理的创新治疗计划。我们建议通过在普通民众中使用行之有效的策略，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.)预计将通过电话和短信、门诊和非专业家长顾问进行干预。这项工作将分两个阶段进行。在第一阶段，被诊断为T1D的幼儿的主要照顾者将收到我们的T.O.T.草案版本，并在干预后接受行为指数和血糖控制的评估。参与者将接受形成性访谈，以提供关于他们在该项目中的经历的丰富的、背景的数据。第一阶段的发现将有助于推动第二阶段的干预改进和额外的贝塔测试：参与者将被随机分为T.O.T.s(治疗)或常规护理(对照)条件。干预部分预计包括：针对改善饮食和身体活动行为的育儿策略，以及T1D管理支持。这些将通过多个医疗机构和变革推动者提供。生物医学和心理社会测量(包括糖化血红蛋白、体力活动、营养、就餐行为、儿科育儿压力、生活质量)将在基线时和最长6个月后进行。这项工作的结果将最终导致一种临床行为疗法，可能会改善幼儿的T1D血糖控制，并可考虑用于进一步的测试和临床翻译。

项目成果

Feasibility of Including Behavioral Feeding Training Within a Parent Intervention for Young Children With Type 1 Diabetes.

• DOI: 10.1007/s10880-018-9577-4
• 发表时间: 2019-06
• 期刊: Journal of clinical psychology in medical settings
• 影响因子: 2.2
• 作者: Tully C;Ahrabi-Nejad C;Birch LL;Mackey E;Streisand R
• 通讯作者: Streisand R

Promoting glycemic control in young children with type I diabetes: Results from a pilot intervention for parents.

• DOI: 10.1037/fsh0000672
• 发表时间: 2022-06
• 期刊: FAMILIES SYSTEMS & HEALTH
• 影响因子: 1.3
• 作者: Mackey, Eleanor R.;Tully, Carrie;Rose, Meredith;Hamburger, Samantha;Wang, Jichuan;Herrera, Nicole;Cogen, Fran;Henderson, Celia;Monaghan, Maureen;Hornack, Sarah;Streisand, Randi
• 通讯作者: Streisand, Randi

Parenting Intervention to Improve Nutrition and Physical Activity for Preschoolers with Type 1 Diabetes: A Feasibility Study.

改善 1 型糖尿病学龄前儿童营养和身体活动的育儿干预：可行性研究。

• DOI: 10.1016/j.pedhc.2018.04.019
• 发表时间: 2018
• 期刊: Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
• 作者: Tully,Carrie;Mackey,Eleanor;Aronow,Laura;Monaghan,Maureen;Henderson,Celia;Cogen,Fran;Wang,Jichuan;Streisand,Randi
• 通讯作者: Streisand,Randi