Support to Adopt and Retain Technology (StART) CGM: A pilot study to support continuous glucose monitoring in primary care

项目摘要/摘要 候选人：Kara R.Mizokami-Stout，医学博士，理学硕士，成年内分泌学家和早期职业调查员 关于个性化糖尿病管理，以改善健康结果。水上-斯托特博士的长期职业生涯 目标是成为一名独立的医生-调查员，促进循证的、系统的水平 预防糖尿病并发症和改善糖尿病特有的生活质量的变化。 研究背景：持续血糖监测(CGM)改善血糖控制，减少低血糖 并促进需要胰岛素的2型糖尿病(T2D)的个性化护理。尽管有这些好处，只有3%的人 初级保健中符合条件的T2D患者正在使用CGM设备，近三分之一的CGM用户停止使用CGM 六个月后使用这些设备。综合评估和协调一致的战略，瞄准重点 T2D缺乏CGM采用和保留的决定因素，特别是在初级保健环境中 90%的T2D患者接受了糖尿病治疗。在多个层面解决决定因素的干预措施 需要有影响力的人员(例如，患者、提供者、卫生系统)来实现这种协调交付和改进 CGM治疗需要胰岛素的T2D的疗效。 研究目标：Mizokami-Stout博士将利用实施科学(通过在 慢性病检查表)以：(1)深入了解患者、提供者和系统级别 使用CGM的障碍和促进者；(2)设计以证据和理论为基础的多层次干预措施，题为 支持采用和保留技术(Start)CGM，以解决采用CGM的关键决定因素，并 保留；以及(3)评估START CGM改善CGM的可行性、可接受性和初步效果 在初级保健中采用和保留需要胰岛素的T2D。 职业发展计划：Mizokami-Stout博士将在以下方面发展专业知识：(1)实施科学 干预措施的开发和评估；(2)利用电子技术设计多层次、量身定制的干预措施 健康记录；3)实用试验的混合方法评价。Mizokami-Stout博士的培训将是 由经验丰富的跨学科导师提供支持；高级教学课程；以及参与 在理想的培训环境中召开研究和职业发展会议和研讨会。NIDDK K-23 该奖项将使Mizokami-Stout博士成为一名独立的医生兼研究员，并在 开发、测试和实施多层次干预措施以纳入循证糖尿病 将科技应用于糖尿病的常规护理。

PROJECT SUMMARY/ABSTRACT Candidate: Kara R. Mizokami-Stout, MD, MSc is an adult endocrinologist and early career investigator focused on personalized diabetes management to improve health outcomes. Dr. Mizokami-Stout’s long-term career objective is to become an independent physician-investigator who promotes evidence-based, system-level changes to prevent diabetic complications and improve diabetes-specific quality-of-life. Research Context: Continuous glucose monitoring (CGM) improves glycemic control, reduces hypoglycemia and facilitates personalized care in insulin-requiring type 2 diabetes (T2D). Despite these benefits, only 3% of eligible T2D patients seen in primary care are utilizing CGM devices and nearly one-third of CGM-users stop using these devices after six months. A comprehensive evaluation and a coordinated strategy to target key determinants of CGM adoption and retention is lacking for T2D, particularly in primary care settings where over 90% of patients with T2D receive their diabetes care. Interventions that address determinants at multiple levels of influence (e.g., patient, provider, health system) are required to achieve such coordinated delivery and improve effectiveness of CGM in insulin-requiring T2D. Research Aims: Dr. Mizokami-Stout will utilize Implementation Science (via the Tailored Implementation in Chronic Diseases checklist) to: (1) develop an in-depth understanding of patient-, provider-, and system-level barriers and facilitators to CGM use; (2) design an evidence- and theory-based multilevel intervention entitled Support to Adopt and Retain Technology (StART) CGM that addresses key determinants of CGM adoption and retention; and (3) evaluate the feasibility, acceptability, and preliminary efficacy of StART CGM to improve CGM adoption and retention in insulin-requiring T2D in primary care. Career Development Plan: Dr. Mizokami-Stout will develop expertise in: (1) Implementation Science for intervention development and evaluation; (2) designing multilevel, tailored interventions utilizing the electronic health record; and 3) mixed methods evaluation of pragmatic trials. Dr. Mizokami-Stout’s training will be supported by highly experienced, interdisciplinary mentors; advanced didactic coursework; and participation in research and career development meetings and seminars within an ideal training environment. An NIDDK K-23 award will allow Dr. Mizokami-Stout to become an independent physician-investigator and national leader in developing, testing and implementing multilevel interventions to incorporate evidence-based diabetes technology into routine diabetes care.