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

项目总结/摘要 候选人：卡拉·R. Mizokami-Stout，医学博士，理学硕士是一位成年内分泌学家和早期职业调查员，专注于 个性化糖尿病管理，以改善健康结果。Mizokami-Stout博士的长期职业生涯 目标是成为一个独立的医生，研究者谁促进循证，系统级 预防糖尿病并发症和改善糖尿病患者的生活质量。 研究背景：动态血糖监测（CGM）可改善血糖控制，减少低血糖 并有助于胰岛素依赖型2型糖尿病（T2 D）的个性化护理。尽管有这些好处，只有3%的 初级保健中合格的T2 D患者正在使用CGM设备，近三分之一的CGM用户停止使用 在六个月后使用这些设备。全面评价和协调战略， T2 D患者缺乏CGM采用和保留的决定因素，特别是在初级保健环境中， 90%的T2 D患者接受糖尿病护理。在多个层面处理决定因素的干预措施 影响力（例如，患者、提供者、卫生系统）来实现这种协调的递送并改善 CGM在需要胰岛素的T2 D中的有效性。 研究目标：Mizokami-Stout博士将利用实施科学（通过 慢性病检查表），以：（1）深入了解患者，提供者和系统级 CGM使用的障碍和促进因素;（2）设计一个基于证据和理论的多层次干预， 支持采用和保留技术（StART）CGM，解决CGM采用的关键决定因素， 评价StART CGM改善CGM的可行性、可接受性和初步疗效 在初级保健中需要胰岛素的T2 D患者中的采用和保留。 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， 干预措施的制定和评价;（2）设计多层次的，有针对性的干预措施，利用电子 健康档案; 3）混合方法评价的实用性试验。水神斯托特博士的训练 由经验丰富的跨学科导师支持;先进的教学课程;并参与 在理想的培训环境中举行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调查员和国家领导人， 制定、测试和实施多层次干预措施， 技术应用于常规糖尿病护理。

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.