Optimizing diabetes technology use for Latinx youth through DREAM (Device use Reimagined through Education And Mentorship) virtual peer groups

通过 DREAM（通过教育和指导重新构想设备使用）虚拟同伴小组，优化拉丁裔青少年的糖尿病技术使用

• 批准号: 10708963
• 负责人: Jennifer K Raymond
• 金额: $ 49.95万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708963
• 关键词: Achievement; Address; Adolescent; Adolescent and Young Adult; Adoption; Attitude; Black race; California; Caring; Childhood; Childhood diabetes; Clinic; Clinical; Clinical Trials; Collaborations; Communities; Complications of Diabetes Mellitus; Continuous Glucose Monitor; Data; Development; Device Designs; Devices; Diabetes Mellitus; Doctor of Philosophy; Education; Endocrinologist; Ethnic Population; Evaluation; Family; Feedback; Focus Groups; Geography; Glycosylated hemoglobin A; Goals; Grant; Happiness; Health; Health Personnel; Insulin; Insulin Infusion Systems; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; Knowledge; Latinx; Latinx population; Los Angeles; Maintenance; Measures; Medical; Mentorship; Modeling; Outcome; Participant; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Pediatric Hospitals; Peer Group; Persons; Phase; Population; Population Heterogeneity; Process Measure; Provider; Psychologist; Public Health; Pump; Quality of life; Race; Randomized; Randomized, Controlled Trials; Readiness; Reporting; Research; Research Personnel; San Francisco; Structure; System; Technology; Universities; Visit; Work; Youth; acceptability and feasibility; adverse outcome; age group; aged; blood glucose regulation; clinical center; comparison control; design; diabetes distress; diabetes risk; diabetes self-management; ethnic diversity; experience; feasibility testing; future implementation; glycemic control; group intervention; health care service utilization; high risk; hospital utilization; improved; marginalization; medical appointment; member; monitoring device; multidisciplinary; novel; optimism; patient engagement; peer; peer support; pilot test; prevent; primary outcome; programs; randomized, clinical trials; recruit; satisfaction; social; stakeholder perspectives; standard care; telehealth; therapy design; uptake; virtual

PROJECT SUMMARY/ABSTRACT Strict glycemic control is critical for optimal type 1 diabetes (T1D) outcomes but remains challenging for youth from historically marginalized ethnic groups, in whom hemoglobin A1c (A1c) levels are consistently the highest in the nation. In California, Latinx youth are the largest marginalized ethnic group with T1D, but they experience less optimal glycemic control than their White counterparts. Continuous glucose monitoring, insulin pumps, and automated insulin delivery systems can assist with achievement of target A1c levels, but Latinx youth have lower rates of diabetes device use compared to White youth. Virtual peer groups (VPGs) can improve patient engagement and diabetes self-care in Latinx youth, and preliminary data suggest that VPGs may increase the use of diabetes technology in this population. Jenise Wong, MD PhD, and Jennifer Raymond, MD MCR, propose this project grant with the objective to increase the adoption and sustained use of diabetes devices in Latinx adolescents with T1D by engaging them and their families in the development and evaluation of a VPG intervention designed to improve technology use. This project will engage multiple stakeholders (patients, families, health care workers) from three clinic populations in California (Children’s Hospital of Los Angeles, University of California Davis, and University of California San Francisco) and result in the DREAM (Device use Reimagined through Education And Mentorship) program. In collaboration with a multidisciplinary team of pediatric endocrinologists, psychologists, and public health experts, the researchers propose a project with the following aims: (1) partner with stakeholders to adapt a virtual peer group model to promote the initiation and continued use of diabetes technology among Latinx adolescents with T1D, (2) evaluate the feasibility and acceptability of DREAM in a single arm, pragmatic trial, and (3) assess the effect of DREAM on clinical and patient-centered outcomes. These aims will be addressed in a formative phase and a clinical trial phase. In Phase 1, the research team will address Aim 1 by engaging stakeholders in focus groups and semi-structured interviews to obtain qualitative data that will directly inform the design of the DREAM VPGs and the clinical trial. A subset of stakeholders will form Advisory Councils who will provide longitudinal input during the clinical trial. In Phase 2, the research team will conduct a single arm, pragmatic trial of the DREAM intervention in 120 Latinx youth aged 13 to <18 years with T1D, recruited from three pediatric diabetes clinic populations in California. To address Aim 2, the researchers will collect qualitative feedback from focus groups and quantitative data on VPG feasibility, appropriateness, and acceptability as primary outcomes. Preliminary data on clinical outcomes of A1c and hospital utilization, and patient-centered outcomes will be assessed to address Aim 3. The results of this study will result in a novel, culturally appropriate, VPG model to increase use of diabetes technology for Latinx youth with T1D that may be further adapted and disseminated for other age groups, geographic settings, or racial/ethnic populations.

项目总结/文摘