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Strengths-Based Multi-Level Behavioral Intervention to Promote Resilience and Self-Management in Youth with Type 1 Diabetes

基于优势的多层次行为干预可促进 1 型糖尿病青少年的复原力和自我管理

基本信息

批准号：
10667615
负责人：
Marisa Ellen Hilliard
金额：
$ 73.94万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-20 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10667615
关键词：
Adherence Adolescence Adolescent Age Appointment Behavior Behavior Therapy Behavioral Caring Child Childhood Childhood diabetes Chronic Clinic Clinical Clinical Data Communication Conflict (Psychology)Data Deterioration Development Diabetes Mellitus Dose Early Intervention Educational process of instructing Electronic Health Record Ethnic Origin Family Future Glucose Glycosylated hemoglobin A Goals Health Health Technology Health behavior Health behavior change Healthcare Healthcare Systems Individual Insulin-Dependent Diabetes Mellitus Intervention Linguistics Mediating Mediator Medical Methods Modeling Outcome Parents Participant Patient Outcomes Assessments Pattern Persons Physiological Pilot Projects Prevention Preventive Provider Quality of life Race Randomized Reporting Research Risk Science Self Management Social support Structure System Targeted Research Testing Theory of Change Time Training Visit Washington Youth arm behavioral adherence brief intervention care providers diabetes distress diabetes management diabetes self-management digital health education resources expectation experience follow-up glycemic control health related quality of life high risk improved innovation intervention effect medical appointment meetings mobile application multi-component intervention novel peer post intervention prevent preventive intervention primary outcome promote resilience provider intervention psychosocial psychosocial wellbeing recruit resilience satisfaction secondary outcome social social cognitive theory socioeconomics theories tool treatment arm treatment as usual

项目摘要

PROJECT SUMMARY/ABSTRACT Type 1 diabetes (T1D) management is particularly challenging during the transition to adolescence, as this developmental period is often marked by increasing expectations for independence in self-management and poorer glycemic and quality of life outcomes. In behavioral T1D research (largely conducted with adolescents), there has been limited evidence of meaningful, lasting impact on adherence behaviors or glycemic outcomes. Novel, developmentally appropriate approaches are needed to help youth achieve “diabetes resilience” – i.e., engage in high levels of self-management behaviors, achieve HbA1c levels within the target range, and experience good quality of life – during the important late childhood and early adolescent years. Prevention science and social-ecological theories of health behavior change for pediatric health conditions recognize the importance of early interventions that target multiple systems surrounding a child with a chronic condition like T1D to promote trajectories of positive behavioral, psychosocial, and medical outcomes. The goal of this study is to evaluate a new intervention for youth age 8-12 with T1D and elevated HbA1c that uses strengths-based methods to prevent the deterioration in outcomes often observed in adolescence. In this 6-month, multi-modal intervention: (1) diabetes care providers will use youth- and parent-reports of youth’s diabetes strengths and self-management behaviors to lead a discussion of what youth are doing well for T1D during a routine diabetes care appointment, (2) parents will use an app to recognize, track, and reinforce their children’s positive T1D- related behaviors and will have “3 minute meetings” with their child about a T1D self-management goal, and (3) youth will use an app to have positive interactions with parents about their diabetes strengths and build supportive social connections with peers through videos about living well with T1D. The intervention strategies are brief, low-burden, and use digital health technologies to deliver the intervention in the context of real-world diabetes activities (i.e., routine medical appointments and everyday T1D management). We will test this intervention with 250 racially/ethnically, socioeconomically, and linguistically diverse youth in Houston, TX and Washington, DC, who are randomly assigned to the intervention or enhanced usual care. Our goal is to evaluate the intervention’s impact on key T1D outcomes: HbA1c, % glucose time in range, engagement in T1D self- management behaviors, and health-related quality of life. We will also examine psychosocial and intervention- specific factors that may be mechanisms of the intervention’s effect. Data will be collected for 15 months. The ultimate goal of this research is to test the effects of a multi-level, strengths-based preventive intervention on health behaviors, psychosocial well-being, and T1D health outcomes during the critically important and understudied developmental stage of the transition to adolescence. Results will inform future intervention strategies to maximize resilient outcomes for youth with T1D who are at elevated risk for poor outcomes.

项目总结/文摘