Fear of Hypoglycemia Survey: Properties, Interpretation and Dissemination

描述（申请人提供）：拟议项目是对PA-06-151二级数据分析的回应，并将利用以前从弗吉尼亚大学进行的NIH资助的研究中收集的一组独特的数据（n = > 2500）和世界各地的其他研究（n > 3500）对低血糖恐惧调查（HFS）和低血糖恐惧（FOH）进行深入调查。在糖尿病中，低血糖可能与许多负面后果有关，从不愉快的症状和社交尴尬到身体伤害甚至危及生命的情况。因此，FOH被认为是实现最佳血糖控制的主要心理障碍之一。因此，科学地研究FOH，了解其对生活质量和糖尿病控制的影响，并减少其对糖尿病患者的潜在负面影响至关重要。要做到这一点，必须有一种方法来量化或测量这种糖尿病特有的焦虑形式。HFS是由我们的研究小组专门设计的33项问卷，用于测量1）对低血糖及其负面后果的担忧和2）避免低血糖及其潜在影响的行为。最初的HFS旨在测量1型糖尿病成人的FOH，但随后开发了用于1型糖尿病儿童，2型糖尿病成人和患者家庭成员的版本，他们也可能经历FOH。HFS还被翻译成至少12种语言，并在至少16个不同国家的糖尿病研究中使用，通常作为行为干预，糖尿病药物和新兴治疗和技术（包括胰岛细胞移植和连续葡萄糖传感器）临床试验的结果指标。尽管它的广泛效用和使用，很少有人知道的心理测量特性的HFS，所以没有经验的基础上解释的分数或比较患者群体和文化。拟议的项目将创建一个大型的国际数据集，并提供急需的机会，以生成不同患者亚组的规范性HFS数据，评估HFS的可靠性和有效性，并开始检查不同文化和全球地区的FOH差异。然后，将开发一个HypoFear门户网站，以便科学界能够方便地获得这些心理测量结果，并促进对HFS的基于实验的解释。这将是糖尿病研究人员的宝贵资源，也有助于在临床环境中使用HFS来识别有问题的FOH患者。此外，拟议的项目将利用这些大型数据集提供的前所未有的机会，探索有关FOH发展的一些重要假设，及其对糖尿病患者生活质量，糖尿病管理和医疗结果的影响。公共卫生相关性：低血糖恐惧症（FOH）对糖尿病患者的生活质量和医疗结果有显著的负面影响，因此科学地研究FOH具有重要意义。地球仪中最常用的FOH测量方法是低血糖恐惧调查（HFS），但对于不同患者群体的正常恐惧水平以及调查的可靠性和有效性知之甚少，这是理解FOH以及如何减少FOH的主要障碍。（来自世界各地的6，000多项调查），该项目提供了一个独特的机会来回答有关HFS和FOH的重要问题，创建一个网站，为糖尿病研究社区提供研究FOH所需的信息，并帮助糖尿病患者减少FOH对他们生活的负面影响。

DESCRIPTION (provided by applicant): The proposed project is a response to PA-06-151 for secondary data analysis, and will take advantage of a unique set of previously collected data from NIH-funded studies conducted at the University of Virginia (n = > 2500) and other studies around the world (n > 3500) to conduct an in-depth investigation into the Hypoglycemia Fear Survey (HFS) and fear of hypoglycemia (FOH). In diabetes, hypoglycemia can be associated with numerous negative consequences ranging from unpleasant symptoms and social embarrassment to physical injury and even life-threatening situations. For this reason, FOH is considered one of the major psychological barriers to achieving optimal glucose control. Thus, it is critical to study FOH scientifically, understand its impact on quality of life and diabetes control, and reduce its potential negative effect on people living with diabetes. To do this, there must be a way to quantify, or measure, this diabetes-specific form of anxiety. The HFS is a 33-item questionnaire, specifically designed by our research group to measure 1) worry about hypoglycemia and its negative consequences and 2) behaviors to avoid hypoglycemia and its potential effects. The original HFS was designed to measure FOH in adults with type 1 diabetes, but versions were subsequently developed for children with type 1 diabetes, adults with type 2 diabetes, and patients' family members, who may also experience FOH. The HFS has also been translated into at least 12 languages and used in diabetes research in at least 16 different countries, often as an outcome measure in clinical trials of behavioral interventions, diabetes medications, and newly emerging treatments and technologies, including islet cell transplants and continuous glucose sensors. In spite of its widespread utility and use, little is known about the psychometric properties of the HFS, so there is no empirical basis for interpretation of scores or comparisons across patient groups and cultures. The proposed project will create a large, international data set and provide the much-needed opportunity to generate normative HFS data for different patient subgroups, assess the reliability and validity of the HFS, and begin to examine differences in FOH across cultures and global regions. A HypoFear Web portal site will then be developed in order to provide easy access to these psychometric findings to the scientific community and promote empirically-based interpretation of the HFS. This will be an invaluable resource for diabetes researchers and also facilitate the use of the HFS in clinical settings to identify patients with problematic FOH. In addition, the proposed project will take advantage of the unprecedented opportunity provided by these large data sets to explore a number of important hypotheses regarding the development of FOH, and its impact on quality of life, diabetes management, and medical outcome for people living with diabetes. PUBLIC HEALTH RELEVANCE: In people with diabetes, fear of hypoglycemia (FOH) can have a significant negative impact on quality of life and medical outcome, and therefore it is important to study FOH scientifically. The most commonly used measure of FOH around the globe is the Hypoglycemia Fear Survey (HFS), but little is known about what constitutes normal levels of fear in different patient groups, or the reliability and validity of the survey, and this is a major barrier to understanding FOH and how to reduce it. By gathering and analyzing large pre-existing sets of HFS data (over 6,000 surveys from around the world), this project provides a unique opportunity to answer important questions about the HFS and FOH, create a website to provide the diabetes research community with information they need to study FOH, and help people with diabetes reduce the negative impact of FOH on their lives.