Application of the Telemedicine for Reach, Education, Access, and Treatment delivery model to engage emerging adults in Diabetes Self-Management Education and Support (TREAT-ED)

应用远程医疗覆盖、教育、获取和治疗提供模式，让新兴成年人参与糖尿病自我管理教育和支持 (TREAT-ED)

• 批准号: 10651947
• 负责人: INGRID M LIBMAN
• 金额: $ 25.32万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-11 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10651947
• 关键词: Address; Adolescent; Adult; Affect; Behavior; Behavioral; Blood Glucose; COVID-19 pandemic; Caring; Clinic; Clinical; Continuous Glucose Monitor; Control Groups; Data; Decision Making; Development; Devices; Diabetes Mellitus; Education; Effectiveness; Ensure; Exhibits; Feasibility Studies; Future; Goals; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; Lead; Life; Literature; Methods; Modeling; Monitor; Outcome; Parents; Patient Monitoring; Patient Participation; Patients; Persons; Preparation; Problem Solving; Provider; Reporting; Research; Risk; Self Care; Self Management; Series; Services; Specialist; Techniques; Technology; Telemedicine; Testing; Time; Visit; Vulnerable Populations; Work; Youth; age group; behavioral outcome; clinical practice; cohort; collaborative approach; contextual factors; coping; design; design,build,test; diabetes risk; diabetes self-management; effectiveness measure; effectiveness/implementation study; emerging adult; emerging adulthood; experience; glucose monitor; hands-on learning; high risk; implementation determinants; implementation evaluation; implementation outcomes; implementation strategy; improved; improved outcome; interest; novel; novel strategies; patient population; peer support; pilot test; pilot trial; pragmatic trial; primary outcome; programs; prototype; psychosocial; response; satisfaction; skills; telehealth; therapy design; uptake; user centered design

Abstract Diabetes self-management education and support (DSMES) is considered a cornerstone of care and essential in helping people navigate self-management decisions and activities. Despite evidence that DSMES is a critical component of diabetes care, participation remains low. Emerging adulthood (EA) has been described as the distinct period between 18 and 25 years when adolescents work to achieve autonomy and explore life possibilities in moving toward adulthood. Suboptimal self-management has been identified as a major problem in EAs with type 1 diabetes (T1D), a particularly vulnerable group with an increased risk for poor diabetes-related outcomes. In its current form DSMES has been cited for not meeting the needs of EAs, when EAs have expressed interest in DSMES delivered with peer-supported, technological and applied learning-driven methods. To address these challenges, we are applying information gained from the literature and key stakeholders to our established Telemedicine for Reach, Education, Access and Treatment (TREAT) delivery model with a specific focus on DSMES. TREAT-ED (for self-management EDucation) will be designed to specifically engage EAs in DSMES by integrating DSMES objectives to support informed decision making, self-care, and preparation for transfer to adult care, to improve outcomes. Diabetes care and education specialists (DCESs) will lead TREAT- ED with a cohort of EAs and will 1) help to organize and facilitate group sessions delivered through telehealth and 2) use continuous blood glucose monitoring (CGM) reports as personalized examples to drive established DSMES content. With user-centered design techniques, we will evaluate implementation determinants and then develop, build, and test the TREAT-ED model. Feasibility assessment of the impact of the model on EA patient participation in DSMES along with clinical, psychosocial and behavioral outcomes will be examined. We hypothesize that models that rely on current day strategies to engage EAs at high risk for diabetes-related problems with effective self-management skills will improve DSMES engagement and outcomes. If proven to be effective, this model is one that could be adapted for EAs who have transferred to adult diabetes care and other patient populations throughout the US.

摘要