Leveraging Social Media to Improve Health Outcomes in Adolescents with Diabetes

项目摘要/摘要 这份建议描述了一个为期五年的研究培训计划，使我能够实现我的长期目标 成为一名独立的教职员工和科学家，致力于提高医疗质量和患者健康 患有糖尿病的年轻人。美国大多数患有1型糖尿病(T1D)的青少年并不是 达到治疗目标。我建议开发工具来提供创新的糖尿病管理支持，以 通过使用社交媒体(SM)在诊所环境之外的青少年，并评估其可行性和 对患有T1D的青少年的接受度。SM已经成为青少年生活中不可或缺的一部分，在这个时候， 缺乏高质量的实证研究来调查SM在医疗保健环境中的使用情况。 考虑到需要有效的干预措施来支持青少年的T1D管理，这项工作具有潜力 为这一脆弱人群的疾病管理带来重大进展。 这项建议的目标是开发一种以患者为中心的SM干预，以提高患者的自我效能 并改善患有T1D的青少年的健康状况。我将通过首先确定以下几个目标来实现此目标 针对不同阶段的青少年糖尿病患者采取不同的SM干预策略。在目标1中，我计划 对患有T1D的青少年进行大样本调查，以检验人们对如何利用SM的看法 在糖尿病管理中，然后使用潜在类分析技术，我将根据以下几个方面对青少年进行细分 患者的特点和喜好围绕SM的使用。在目标2中，我将纳入更多的利益相关者 通过使用以用户为中心的设计研讨会提供意见，包括护理人员和医疗团队成员 在以前的形成性工作的基础上，开发SM干预试点。通过让青少年、照顾者、 和医疗保健团队成员在迭代过程中以用户为中心的设计研讨会，我希望开发一个 与关键利益相关者的价值观、偏好和目标一致的SM干预。在《目标3》中，我将驾驶 采用随机对照试验进行SM干预，并检验其可行性和可接受性。另外，我计划 探讨对患者报告的结果(例如自我效能)和血糖控制的影响。 我的研究将得到一群在社交媒体研究方面拥有专业知识的杰出导师的支持， 儿科糖尿病的调查研究和临床干预措施的设计。通过实现这一目标 提案中，我将解决目前我们对如何利用SM支持青少年的理解上的差距 慢性病。此外，这项提议将使我能够在我的研究培训中采取下一步关键步骤 通过为我提供机会来获取设计、评估和 利用社交媒体实施行为健康干预。最终，这项提议将使我能够建立一个 研究计划，研究以系统为导向、以患者为中心的解决方案，以提高交付和质量 为患有糖尿病的年轻人提供医疗服务。

PROJECT SUMMARY/ABSTRACT This proposal describes a five-year research training program that will allow me to achieve my long-term goal of becoming an independent faculty-scientist dedicated to improving healthcare quality and patient health for youth with diabetes. The majority of adolescents with type 1 diabetes (T1D) in the United States are not meeting the goals of therapy. I propose to develop tools to provide innovative diabetes management support to adolescents outside of the clinic setting through the use of social media (SM) and evaluate its feasibility and acceptability to adolescents with T1D. SM has become an integral part of adolescents’ lives and at this time, there is an absence of high quality empirical studies investigating the use of SM in the healthcare setting. Given the need for impactful interventions to support adolescent T1D management, this work has the potential to result in a major advance for disease management in this vulnerable population. The goal of this proposal is to develop a patient-centered SM intervention that will enhance patient self-efficacy and improve health outcomes for adolescents with T1D. I will achieve this goal by first identifying several different SM intervention strategies for distinct segments of adolescents with diabetes. In Aim 1, I plan to conduct a survey of a large sample of adolescents with T1D to examine perceptions on how SM can be utilized in diabetes management and then using latent class analysis techniques, I will segment adolescents based on patient characteristics and preferences around the use of SM. In Aim 2, I will incorporate additional stakeholder input, including caregivers and healthcare team members, through the use of user-centered design workshops to develop a pilot SM intervention based on previous formative work. By engaging adolescents, caregivers, and healthcare team members in an iterative process of user-centered design workshops I hope to develop a SM intervention that is consistent with key stakeholder values, preferences and goals. In Aim 3, I will pilot the SM intervention in a randomized controlled trial and examine its feasibility and acceptability. In addition, I plan to explore the impact on patient-reported outcomes (e.g. self-efficacy) and glycemic control. My research will be supported by an outstanding group of mentors with expertise in social media research, pediatric diabetes, survey research, and the design of clinical interventions. By accomplishing the aims in this proposal, I will address current gaps in our understanding of how to leverage SM to support adolescents with chronic disease. In addition, this proposal will allow me to take the next critical steps on my research training trajectory by providing me the opportunity to acquire additional research skills required to design, evaluate and implement behavioral health interventions using social media. Ultimately, this proposal will allow me to build a research program to investigate system-oriented, patient-centered solutions to improve the delivery and quality of medical care to youth with diabetes.!