Design and Pilot Test of A Prediabetes Digital Patient Activation Tool

项目摘要/摘要 糖尿病前期是一个重大的公共健康问题，影响着8800万美国成年人，并增加了患糖尿病的风险 患糖尿病的5年风险高达50%。NIDDK优先检查行为方法 预防2型糖尿病。这个应用程序试图通过开发糖尿病前期数字来解决这一优先事项 激活工具，以增加患者的活跃度，这是积极健康结果的关键驱动因素。患者激活 鼓励增强患者的知识和活力，并成为管理中的合作伙伴 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 使用客观工具评估患者的活动情况，这可能会导致他们提出建议， 可能不会被跟踪，或者根本不会提出任何建议。这一障碍可能是导致低利率的原因之一 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，显示 降低患糖尿病的风险。 我们的总体目标是将参与糖尿病预防活动的患者比例提高到 减少糖尿病的发病率。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) 为了开发一种评估患者的激活水平的糖尿病前期数字患者激活工具(DPAT)， 为临床医生生成与糖尿病前期相关的访问目标、引导访问达到该目标的问题，以及 支持将患者从较低激活阶段转移到较高激活阶段的资源列表，以及2)进行 A进行DPAT与常规护理的试验组随机对照试验，评估DPAT与常规护理的主要结果 增加患者活跃度，随后对部分参与者和PCP进行访谈以进行评估 DPAT的可接受性和可行性。目标人群包括患有糖尿病前期和体重指数≥为25 kg/m2的成年人 他们拥有电子健康记录患者门户帐户。 我们假设使用该工具的患者的激活水平将会增加，报告的 满意度和体验，并最终更有可能被登记和参与民进党相比 给常规护理小组的参与者。这项试点研究的数据将提供初步数据来测试 此数字患者激活工具在更大范围的随机研究中对患者激活和DPP登记的有效性 整个医疗系统的对照试验。

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.