Developing a patient-centered psychoeducational tool to realize the potential of diabetes technologies

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PROJECT SUMMARY / ABSTRACT Despite increased use of insulin pumps (IP) and continuous glucose monitors (CGM) for pediatric type 1 diabetes (T1D) management and research studies showing benefits from the use of these devices, real-world glycemic control among youth with T1D has worsened in recent years. The lack of improvement in glycemic control despite increased use of these technologies indicates that youth receiving routine clinical T1D care are not realizing the full potential of IP and CGM. Although greater youth and parental diabetes knowledge is associated with better glycemic control, education alone is not sufficient to bring about the behavioral changes needed to improve outcomes in T1D. Psychoeducation recognizes the need to blend educational and behavioral approaches, including problem-solving and goal-setting, to support parents in developing optimal T1D management approaches. There are currently a lack of effective standardized tools to support patients and families in developing the knowledge and behavioral strategies needed to optimize the use of diabetes technologies. The development of innovative family-centered psychoeducational tools addressing both behavior and knowledge will help to realize the full potential of diabetes technologies to improve glycemic control and quality of life while ultimately preventing or delaying the development of both acute and long-term complications of T1D. The scientific goal of this proposal is to identify the unmet psychoeducational needs of parents of children 8-12 years of age using IP and CGM for pediatric T1D management and to leverage that information to develop an innovative psychoeducational intervention to optimize use of these technologies and improve T1D outcomes. In Aim 1, semantic content analysis of interviews involving children with T1D, their parents, and diabetes clinicians will be used to identify unmet educational and behavioral needs of parents and children using these technologies. We previously developed an app-delivered T1D technology education curriculum for clinicians and in Aim 2 will use instructional design and stakeholder input to adapt the existing curriculum to meet the specific needs of parents of school age children with T1D. Finally, in Aim 3, we will pilot this psychoeducational intervention. Parents will complete 4 months of the app-delivered psychoeducational curriculum and dyads will also meet with a diabetes educator trained in motivational interviewing to reinforce knowledge and problem solving skills learned in the curriculum by applying them to personal IP and CGM data. With the support of my mentors and advisory committee comprised of experts in T1D behavioral interventions, medical and family-facing education, and qualitative research, I will attain the career development goals of learning advanced techniques in qualitative and quantitative research, developing expertise in family-facing psychoeducational interventions, and cultivating the leadership skills needed to translate my findings into clinical practice. This mentored career development award will support my development as an independent investigator capable of harnessing the unmet potential of diabetes technologies. Outcomes will be used to power a randomized controlled trial for a future R01 submission.