Mixed-Methods Study of Sleep in Diverse Young Adults with T1D During and After the Transition from Pediatric to Adult Care.

不同 1 型糖尿病年轻成人从儿科护理过渡到成人护理期间和之后睡眠的混合方法研究。

• 批准号: 10378911
• 负责人: Marisa Ellen Hilliard
• 金额: $ 10.78万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10378911
• 关键词: Accountability; Address; Adherence; Adolescence; Adult; Appointment; Award; Behavioral; Biological Markers; COVID-19 pandemic; Caring; Childhood; Clinic; Data; Development; Diabetes Mellitus; Doctor of Philosophy; Enrollment; Evidence based program; Family; Friends; Glycosylated hemoglobin A; Goals; Health; Healthcare Systems; Hospitalization; Insulin-Dependent Diabetes Mellitus; Intervention; Mediating; Mediation; Mediator of activation protein; Mentorship; Methods; Modeling; Outcome; Parents; Participant; Pediatrics; Personal Satisfaction; Persons; Problem Solving; Provider; Quality of life; Questionnaires; Randomized; Readiness; Recommendation; Reporting; Research; Risk; Role; Safety; Sample Size; Schools; Self Care; Self Management; Sleep; Social support; Source; Testing; Time; Training; Visit; Work; base; depressive symptoms; diabetes distress; diabetes management; diabetes self-management; emerging adult; experience; follow-up; glycemic control; health care settings; high risk; intervention participants; novel; novel strategies; pandemic disease; participant enrollment; peer coaching; peer support; prevent; primary outcome; programs; psychoeducational; psychosocial; recruit; role model; secondary outcome; skills; social; stress management; treatment adherence; treatment as usual; virtual; young adult

PROJECT SUMMARY/ABSTRACT (Parent Award): Type 1 diabetes (T1D) management is challenging for young adults, who assume responsibility for self- management and transfer T1D care from the pediatric to adult healthcare system as they also manage typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended (>6 months) gaps before following up in adult care, which increase their risk for poor health outcomes and serious health complications. There are few evidence-based programs to support young adults with T1D during the transfer period between pediatric and adult care. Novel, developmentally appropriate approaches are needed to help young adults negotiate the challenges of living with T1D and complete a timely transition to adult care. The goal of the proposed study is to evaluate a new intervention for young adults with T1D that maximizes diabetes-related social support. The proposed transition intervention builds on young adults’ social support network and provides them access to relevant information about T1D care in adulthood. Around the time they leave pediatric T1D care, young adults with T1D will be paired with a trained “Peer Mentor,” an experienced, slightly older young adult with T1D, who will meet with them in-person and have frequent (weekly, then monthly) contact for 12 months. During the contacts, the Peer Mentor will use strengths-based psychoeducational strategies to teach and model problem-solving and stress-management skills, encourage the young adult to seek support from their existing social support network (e.g., family, friends) and identify new sources of diabetes-related support, help the young adult prioritize T1D self-care during the very demanding young adult period, share his/her transition experiences and strategies for successfully navigating the adult healthcare system, and prepare the young adult for the first care visit. The Peer Mentor will be a positive role model and source of help, encouragement, and accountability around transition, with the goal of reducing isolation, promoting self-management, and preventing gaps in care. We will test this intervention with 150 young adults randomly assigned to the intervention or usual care. Our main goal is to evaluate the intervention’s impact on important T1D outcomes, such as glycemic control, time to adult care, treatment adherence, and psychosocial well-being. Clinic appointment information, questionnaires, adherence data, and glycemic control biomarkers will be collected at baseline and 6 and 12 months later. The ultimate goal of this research is to validate a supportive intervention that can facilitate T1D self-management and transfer of care during the difficult young adult years and promote optimal T1D health outcomes.

项目摘要/摘要（家长奖）： 1 型糖尿病 (T1D) 的管理对于年轻人来说具有挑战性，因为他们要承担自我管理的责任。 管理并将 T1D 护理从儿科医疗保健系统转移到成人医疗保健系统，因为他们还管理典型的 发展需求（例如社会、财务、工作/学校、居住）。许多年轻人已经延长了 （> 6 个月）在成人护理随访之前存在差距，这增加了他们健康状况不佳的风险，并且 严重的健康并发症。很少有循证项目可以支持患有 T1D 的年轻人 儿科和成人护理之间的转换期。新颖的、适合发展的方法是 需要帮助年轻人应对 1 型糖尿病生活的挑战并及时过渡到 成人护理。拟议研究的目的是评估针对年轻 T1D 患者的新干预措施 最大限度地提高与糖尿病相关的社会支持。拟议的过渡干预措施建立在年轻人的社会 支持网络，并为他们提供有关成年 T1D 护理的相关信息。周围 当他们离开儿科 T1D 护理时，患有 T1D 的年轻人将与经过培训的“同伴导师”配对， 经验丰富、年龄稍大的患有 T1D 的年轻成人，他们将亲自与他们会面，并经常（每周、 然后每月）联系 12 个月。在接触过程中，同伴导师将使用基于优势的方法 教授和示范解决问题和压力管理技能的心理教育策略，鼓励 年轻人从现有的社会支持网络（例如家人、朋友）寻求支持并确定 糖尿病相关支持的新来源，帮助年轻人在最重要的时期优先考虑 T1D 自我护理 要求很高的年轻成人期，分享他/她的过渡经验和成功驾驭的策略 成人医疗保健系统，并为年轻人的首次护理就诊做好准备。同伴导师将是 过渡期间的积极榜样和帮助、鼓励和责任来源，目标是 减少隔离、促进自我管理并防止护理差距。我们将测试这种干预 150 名年轻人被随机分配接受干预或常规护理。我们的主要目标是评估 干预对 T1D 重要结局的影响，例如血糖控制、成人护理时间、治疗 依从性和社会心理健康。诊所预约信息、调查问卷、依从性数据和 将在基线以及 6 个月和 12 个月后收集血糖控制生物标志物。此次活动的最终目的 研究旨在验证一种支持性干预措施，可以促进 T1D 自我管理和护理转移 度过困难的青年时期并促进最佳 T1D 健康结果。