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A Stepped Care Behavioral Intervention Trial for Young Children with T1D

针对 1 型糖尿病幼儿的阶梯式护理行为干预试验

基本信息

批准号：
8963378
负责人：
RANDI STREISAND
金额：
$ 73.09万
依托单位：
CHILDREN'S RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8963378
关键词：
6 year old Adherence Adopted Adoption Affect Aftercare Age Algorithms Anxiety Behavior Behavior Therapy Behavioral Biological Blood Glucose Caregivers Caring Child Child Behavior Child Rearing Childhood Chronic Disease Clinical Communication Complications of Diabetes Mellitus Consultations Counseling Diabetes Mellitus Diagnosis Diet Diet Monitoring Disease Disease Management Eating Educational process of instructing Evaluation Exhibits Family Food Glycosylated hemoglobin A Goals Guidelines Health Hypoglycemia Incidence Individual Inpatients Insulin Insulin-Dependent Diabetes Mellitus Intervention Intervention Trial Knowledge acquisition Lead Life Measurement Measures Medical Mental Depression Modeling Monitor Newly Diagnosed Nursing Faculty Outcome Parenting Education Parents Patient Education Patient Monitoring Patients Pattern Persons Physical activity Predisposition Problem Solving Problem behavior Psychologist Psychosocial Assessment and Care Psychosocial Factor Public Health Quality of Care Quality of life Randomized Regimen Regulation Relative (related person)Research Resources Stress Symptoms Telephone Text Time Training Training Support Translating Work Youth clinical care clinical practice critical period depressive symptoms diabetes education diabetes educator diabetes management diabetes mellitus nursing evidence base experience glucose monitor glycemic control improved indexing innovation insulin sensitivity meetings neuropsychological peer prevent psychosocial public health relevance public health research response skill acquisition therapy design treatment as usual

项目摘要

DESCRIPTION (provided by applicant): The incidence of type 1 diabetes (T1D) in young children (age <6 years) is rising. Disease management guidelines offered by the ADA and other diabetes care organizations place a high burden of responsibility onto these children's parents and caregivers to check blood sugar, administer insulin, and monitor diet and physical activity to maintain tight glycemic control. Unfortunately, this occurs at a vulnerable time in life when children's behavior is unpredictable, their T1D is difficult to control, parenting stress is elevatd, and caregivers are strained by normal child caretaking routines. T1D education and support tends to be highly concentrated at diagnosis/during the inpatient stay, and requires rapid knowledge and skill acquisition on the part of parents. Not all families respond equally well to this teaching model, and many need more guided practice, problem-solving assistance, and behavioral supports than can be offered in a one-size-fits-all patient education approach. Our research will attempt to better meet the needs of individual families through a clinical behavioral stepped care intervention for T1D in parents of young children by using real-time glycemic control and [parental depression indices] to intensify management support when indicated. Primary caregivers of young children (<6 years) newly diagnosed with T1D will be randomized to either a 3- step stepped care (treatment) or usual care (comparison) condition. Stepped care components include: T1D management support delivered by trained lay parent consultants (Step 1), T1D parenting strategies and mealtime behavior management delivered by bachelor's level behavioral assistants (Step 2), and individualized diabetes education/management planning with a certified diabetes nurse educator and [consultation with a diabetes team clinical psychologist] (Step 3). Biomedical and psychosocial measurements (including A1c, depressive symptoms, mealtime behavior, parenting stress, quality of life) will occur at baseline and 3-month intervals for up to 15 months post-diagnosis. The results of this work will ultimately lead to a more practical approach to T1D education and management that can be translated more easily into a variety of clinical practice settings to support young children's T1D management.