Design and Pilot Test of A Prediabetes Digital Patient Activation Tool

糖尿病前期数字患者激活工具的设计和试点测试

• 批准号: 10648646
• 负责人: Eva Tseng
• 金额: $ 12.28万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10648646
• 关键词: Address; Adopted; Adult; Affect; Algorithms; Applications Grants; Assessment tool; Behavior; Behavioral; Blood Pressure; Body Weight decreased; Body mass index; Caring; Case Manager; Clinic; Clinical; Clinical Pathways; Data; Decision Aid; Diabetes Mellitus; Diabetes prevention; Discipline; Electronic Health Record; Elements; Eligibility Determination; Enrollment; Funding; Goals; Health; Health system; Incidence; Individual; Interview; Investments; Knowledge; Lead; Life Style; Measures; Methods; Motivation; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Nutritionist; Outcome; Outcome Measure; Participant; Patient Education; Patient Outcomes Assessments; Patient Preferences; Patient Self-Report; Patients; Persons; Physical activity; Pilot Projects; Play; Prediabetes syndrome; Primary Care Physician; Public Health; Questionnaires; Randomized, Controlled Trials; Readiness; Recommendation; Reporting; Research; Resources; Risk; Risk Reduction; Role; Self Efficacy; Self Management; Target Populations; Time; Training; Visit; Weight; Weight Gain; Work; acceptability and feasibility; clinical practice; design; diabetes prevention program; diabetes risk; digital; effective therapy; effectiveness testing; empowerment; evidence base; experience; health service use; high risk; improved; lifestyle intervention; patient engagement; patient health information; patient portal; patient-level barriers; pilot test; prevent; primary care clinic; primary care clinician; primary outcome; programs; progression risk; psychosocial stressors; response; satisfaction; shared decision making; tool; treatment as usual; uptake

PROJECT SUMMARY/ABSTRACT Prediabetes is a significant public health problem affecting 88 million U.S. adults and increases the risk of developing diabetes with a 5-year risk of up to 50%. The NIDDK has prioritized examining behavioral approaches to preventing type 2 diabetes. This application seeks to address this priority by developing a prediabetes digital activation tool to increase patient activation, which is a key driver of positive health outcomes. Patient activation encourages empowering patients to be knowledgeable and activated, and a collaborative partner in managing his or her health. However, in clinical practice, primary care clinicians (PCP) often do not have the time or training to use objective tools to assess their patient’s activation, which may lead them to making recommendations that may not get followed or not making any recommendations at all. This barrier likely contributes to the low rates of referral and participation in the Diabetes Prevention Program (DPP), a yearlong lifestyle program shown to decrease one’s risk of developing diabetes. Our overarching goal is to increase the percentage of patients engaging in diabetes prevention activities to reduce the incidence of diabetes. To address this need, we propose the following interrelated Specific Aims: 1) To develop a prediabetes digital patient activation tool (DPAT) that evaluates a patient’s activation level, generates for the clinician a visit goal related to prediabetes, questions to guide the visit toward that goal, and a list of resources that support moving the patient from a lower to higher stage of activation, and 2) To conduct a conduct a pilot group-randomized controlled trial of DPAT vs. usual care to assess the primary outcome of increased patient activation, followed by interviews of a subset of participants and PCPs to evaluate acceptability and feasibility of DPAT. The target population includes adults with prediabetes and BMI ≥25kg/m2 who have an electronic health record patient portal account. We hypothesize that patients who use this tool will have an increase in activation levels, report greater satisfaction level and experience, and ultimately, be more likely to be enroll and participate in the DPP compared to participants in the usual care group. Data from this pilot study would provide preliminary data to test the effectiveness of this digital patient activation tool on patient activation and DPP enrollment in a larger randomized controlled trial across a health system.

项目总结/摘要 前驱糖尿病是影响8800万美国成年人的重大公共卫生问题，并且增加了糖尿病的风险。 患糖尿病的风险高达50%。NIDDK优先考虑检查行为方法 预防2型糖尿病。本申请旨在通过开发糖尿病前期数字 激活工具，以增加患者的激活，这是积极的健康结果的关键驱动因素。患者激活 鼓励赋予患者知识和活力，以及管理中的合作伙伴 他或她的健康。然而，在临床实践中，初级保健临床医生（PCP）往往没有时间或培训 使用客观的工具来评估他们的病人的激活，这可能会导致他们提出建议， 可能不会被关注或根本不提出任何建议。这一障碍可能有助于低利率的 推荐和参与糖尿病预防计划（DPP），这是一项为期一年的生活方式计划， 降低患糖尿病的风险。 我们的总体目标是增加参与糖尿病预防活动的患者比例， 降低糖尿病的发病率。为了满足这一需求，我们提出了以下相互关联的具体目标：1） 为了开发糖尿病前期数字患者激活工具（DPAT），以评估患者的激活水平， 为临床医生生成与前驱糖尿病相关的就诊目标、引导就诊朝向该目标的问题，以及 支持将患者从较低激活阶段移至较高激活阶段的资源列表，以及2）进行 a进行一项DPAT与常规治疗的试点组随机对照试验，以评估DPAT的主要结局。 增加患者激活，然后对参与者和PCP的子集进行访谈，以评估 DPAT的可接受性和可行性。目标人群包括糖尿病前期和BMI ≥ 25 kg/m2的成人 拥有电子健康记录患者门户账户的人。 我们假设使用该工具的患者的激活水平会增加，报告更大 满意度和经验，并最终，更有可能被录取，并参加民进党相比， 在常规护理组的参与者。这项试点研究的数据将提供初步数据， 在一项更大的随机化研究中，该数字患者激活工具对患者激活和DPP入组的有效性 在整个卫生系统进行对照试验。