权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Effectiveness Trial of an E-Health Intervention To Support Diabetes Care in Minority Youth

支持少数民族青少年糖尿病护理的电子健康干预措施的有效性试验

基本信息

批准号：
9309224
负责人：
DEBORAH A. ELLIS
金额：
$ 61.64万
依托单位：
WAYNE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-04-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9309224
关键词：
14 year old Address Adolescence Adolescent Adoption Affect African American Appointment Appointments and Schedules Area Behavior Therapy Behavioral Caregivers Caring Child Child Rearing Childhood Chronic Disease Clinic Clinical Clinical Trials Complications of Diabetes Mellitus Computer software Computers Conflict (Psychology)Critical Care Data Deterioration Development Diabetes Mellitus Dose Effectiveness Endocrinology Family Glycosylated hemoglobin A Goals Health Healthcare Healthcare Systems Home environment Hybrids Insulin-Dependent Diabetes Mellitus Intervention Intervention Trial Low income Medical Metabolic Control Minority Monitor Motivation Multicenter Trials Outcome Parents Policies Procedures Publishing Randomized Randomized Clinical Trials Recruitment Activity Research Sampling Schedule Self Management Single Parent Supervision Testing Treatment Efficacy Treatment outcome United States Use Effectiveness Vulnerable Populations Work Youth aged attentional control base behavioral health behavioral health intervention brief intervention child depression clinically significant cost design diabetes education diabetes management dissemination research eHealth effectiveness trial efficacy study efficacy trial evidence base executive function follow-up high risk implementation research implementation science improved improved outcome independent self care innovation intervention effect medical appointment motivational enhancement therapy motivational intervention operation parental monitoring primary caregiver research data dissemination satisfaction successful intervention tool two-arm study

项目摘要

The deterioration in diabetes self-management (DSM) and metabolic control associated with the adolescent developmental period is well known. African American adolescents with Type 1 diabetes (T1D) are at even higher risk for such problems. Research has shown that parenting behaviors such as parental monitoring of adolescent completion of daily diabetes care are critical predictors of youth DSM. Low levels of parental monitoring are even more likely to result in poor DSM among youth with T1D from minority or low income homes. Few studies targeting adolescents have demonstrated that behavioral interventions can improve DSM or metabolic control, and no clinical trials have focused exclusively on African American youth. Furthermore, there have been no published clinical trials of interventions that have targeted parental monitoring of daily diabetes care as a means of improving DSM in adolescents. Computer-delivered, brief interventions have shown promising effects in a number of areas of behavioral health care and may also increase the accessibility of behavioral health interventions to minority families. Our group has recently conducted a pilot efficacy trial to test a brief, three session, computer intervention aimed at increasing parental motivation for supervision and monitoring among caregivers of young, African American adolescents who are beginning to transition to independent self-care. Although the intervention was designed for delivery in diabetes clinics at regularly scheduled appointments, for the purpose of our efficacy pilot, it was delivered either in the clinic or in the home if the family missed their scheduled clinic appointment. Results from the efficacy study suggested that caregivers who received the intervention had significantly higher monitoring of their adolescent’s daily diabetes management. Adolescents whose caregivers received the intervention had significant improvements in metabolic control compared to controls. The purpose of the proposed study is to conduct a multicenter, randomized effectiveness trial of the intervention with 212 African American adolescents with T1D and their primary caregivers recruited from pediatric endocrinology clinics across the United States. A Hybrid 1 design will be used, allowing implementation science questions about barriers/facilitators to intervention adoption in real world pediatric diabetes care clinics to be addressed. Caregiver-adolescent dyads will be randomly assigned to one of two study arms: caregiver motivational computer intervention for parental monitoring of diabetes care or caregiver attention control. The intervention will be delivered at three consecutive clinic appointments occurring over 12 months but will only be delivered in the diabetes clinic to determine if the intervention can improve DSM and health outcomes under real world, effectiveness conditions. Dose effects and moderators of treatment outcomes will also be evaluated. If successful, the intervention has the potential to improve health outcomes and to contribute to the integration of behavioral health interventions into routine medical care in a vulnerable population of youth.

糖尿病自我管理（DSM）和代谢控制恶化与青少年相关