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

项目总结/摘要 尽管胰岛素泵（IP）和动态血糖监测仪（CGM）在儿童1型糖尿病中的使用增加， (T1D)管理和研究表明，使用这些设备，现实世界的血糖 近年来，T1 D青年的控制情况恶化。血糖控制缺乏改善，尽管 这些技术的使用增加表明，接受常规临床T1 D护理的年轻人没有意识到 充分发挥IP和CGM的潜力。虽然更多的年轻人和父母的糖尿病知识与更好的 血糖控制，教育本身是不足以带来所需的行为改变，以改善 T1 D的结果。心理教育认识到需要融合教育和行为方法， 包括解决问题和设定目标，以支持父母制定最佳的T1 D管理 接近。目前缺乏有效的标准化工具来支持患者和家庭， 开发优化糖尿病技术使用所需的知识和行为策略。的 开发创新的以家庭为中心的心理教育工具，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，改善血糖控制和生活质量，同时 最终预防或延迟T1 D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岁儿童的父母未满足的心理教育需求 使用IP和CGM进行儿科T1 D管理，并利用这些信息开发创新的 心理教育干预，以优化这些技术的使用，并改善T1 D的结果。在目标1中， 将对T1 D儿童及其父母和糖尿病临床医生的访谈进行语义内容分析， 用于确定使用这些技术的父母和儿童未满足的教育和行为需求。我们 之前为临床医生开发了一个应用程序交付的T1 D技术教育课程，Aim 2将使用 教学设计和利益相关者的投入，以适应现有的课程，以满足家长的具体需要， 学龄儿童T1 D最后，在目标3中，我们将试行这种心理教育干预。父母会 完成4个月的应用程序提供的心理教育课程和二人组也将满足糖尿病 接受过激励性访谈培训的教育家，以加强在培训中学到的知识和解决问题的技能。 通过将其应用于个人IP和CGM数据来进行课程。在我的导师和顾问的支持下 委员会由T1 D行为干预、医疗和家庭教育方面的专家组成， 质的研究，我将达到学习先进的技术在定性和职业发展的目标， 定量研究，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。这个指导性职业发展奖 我将支持我作为一个独立的调查员的发展，能够利用未满足的潜力， 糖尿病技术结局将用于为未来R 01提交的随机对照试验提供动力。

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.