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

开发以患者为中心的心理教育工具，以实现糖尿病技术的潜力

• 批准号: 10449583
• 负责人: Brynn E Marks
• 金额: $ 18.37万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10449583
• 关键词: 12 year old; Acute; Address; Adult; Advisory Committees; Behavior; Behavior Therapy; Behavioral; Caring; Child; Child Care; Childhood; Chronic; Clinical; Controlled Clinical Trials; Data; Development; Devices; Diabetes Mellitus; Education; Educational Curriculum; Educational process of instructing; Endocrinology; Evaluation; Family; Future; Glycosylated hemoglobin A; Goals; Growth and Development function; Incidence; Individual; Instruction; Insulin Infusion Systems; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; K-Series Research Career Programs; Knowledge; Leadership; Learning; Medical; Medical Education; Mentors; Mentorship; Methodology; Multicenter Studies; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Parents; Patients; Persons; Physicians; Problem Solving; Process; Provider; Qualitative Research; Quality of life; Randomized Controlled Trials; Research; Research Personnel; Sampling; School-Age Population; Scientist; Semantics; Standardization; Techniques; Technology; Testing; Time; Training; Translating; Youth; acceptability and feasibility; base; career development; clinical practice; design; diabetes educator; diabetes management; diabetes self-management; early adolescence; education research; eligible participant; experience; glucose monitor; glycemic control; health related quality of life; improved; improved outcome; innovation; motivational enhancement therapy; novel; parental monitoring; patient oriented; prevent; psychoeducation; psychoeducational; psychoeducational intervention; recruit; research study; satisfaction; skills; tool; uptake

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.

项目摘要/摘要 尽管在儿童1型糖尿病中增加了胰岛素泵(IP)和连续血糖监测仪(CGM)的使用 (T1D)管理和研究研究显示使用这些设备的好处，现实世界中的血糖 近年来，患有T1D的年轻人的控制情况有所恶化。在血糖控制方面缺乏改善，尽管 这些技术的使用增加表明，接受常规临床T1D护理的年轻人没有意识到 充分发挥IP和CGM的潜力。尽管更多的年轻人和父母对糖尿病的了解与更好的 血糖控制，仅靠教育不足以带来改善所需的行为改变 T1D的转归。心理教育认识到需要将教育方法和行为方法相结合， 包括解决问题和设定目标，以支持家长发展最佳的T1D管理 接近了。目前缺乏有效的标准化工具来支持患者和家属 开发优化糖尿病技术使用所需的知识和行为策略。这个 开发创新的以家庭为中心的心理教育工具，同时解决行为和知识问题 将有助于充分发挥糖尿病技术的潜力，以改善血糖控制和生活质量，同时 最终预防或延缓T1D急性和长期并发症的发展。 这项建议的科学目标是确定8-12岁儿童的父母未得到满足的心理教育需求。 使用IP和CGM进行儿科T1D管理的年龄，并利用该信息开发创新的 心理教育干预，以优化这些技术的使用，改善T1D结果。在目标1中， 对患有T1D的儿童、他们的父母和糖尿病临床医生的采访的语义内容分析将是 用于识别使用这些技术的父母和孩子未得到满足的教育和行为需求。我们 之前为临床医生开发了由APP提供的T1D技术教育课程，在Aim 2中将使用 教学设计和利益相关者的意见，以调整现有的课程，以满足家长的特定需求 学龄儿童患有T1D。最后，在目标3中，我们将试行这种心理教育干预。父母会的 完成4个月的APP提供的心理教育课程，DYADS也将遇到糖尿病 受过激励性访谈培训的教育者，以加强在 课程，将它们应用于个人知识产权和CGM数据。在我的导师和顾问的支持下 由T1D行为干预、医疗和面向家庭的教育专家组成的委员会，以及 质的研究，我会达到职业发展的目标，学习先进的技术在质和 量化研究，发展面向家庭的心理教育干预的专业知识，并培养 将我的发现转化为临床实践所需的领导技能。这个辅导式职业发展奖 将支持我作为一名独立调查员的发展，能够利用 糖尿病技术。结果将被用来为未来R01提交的随机对照试验提供动力。