Optimizing Use of Advanced Diabetes Technology for Self-Management in Adolescents with Type 1 Diabetes: Integration of Real-Time Glucose and Narrative Data

优化使用先进糖尿病技术对 1 型糖尿病青少年进行自我管理：实时血糖和叙述数据的集成

• 批准号: 10569293
• 负责人: Melissa DeJonckheere
• 金额: $ 15.79万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569293
• 关键词: 18 year old; Acute; Adherence; Adolescence; Adolescent; Adolescent Development; Adolescent Health Services; Affect; Age; Award; Behavior; Behavioral; Biological Process; Blood Glucose Self-Monitoring; Cardiovascular Diseases; Caring; Child; Childhood; Chronic; Clinical Trials; Collection; Communities; Complex; Continuous Glucose Monitor; Data; Data Collection; Dedications; Development; Development Plans; Devices; Diabetes Mellitus; Diabetic Ketoacidosis; Ecological momentary assessment; Environment; Environmental Risk Factor; Evaluation; Family Practice; Feedback; Glucose; Glycosylated hemoglobin A; Goals; Health; Hormonal Change; Hypoglycemia; Incidence; Individual; Institution; Insulin; Insulin Infusion Systems; Insulin Resistance; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Trial; K-Series Research Career Programs; Kidney Diseases; Knowledge; Knowledge acquisition; Learning; Life; Life Expectancy; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Michigan; Morbidity - disease rate; Natural Language Processing; Neuropathy; Outcome; Patients; Pilot Projects; Problem Solving; Process; Psychosocial Factor; Pump; Quality of life; Recommendation; Regimen; Regulation; Research; Research Personnel; Retinal Diseases; Risk; Self Management; Short-Term Memory; Structure; Techniques; Technology; Testing; Theory of Change; Time; Training; Translating; Treatment Protocols; United States; Universities; Well in self; acceptability and feasibility; adolescent health; adolescent health outcomes; age group; arm; behavior change; career; career development; critical period; data integration; data streams; design; diabetes distress; education research; efficacy outcomes; executive function; experience; feasibility testing; glycemic control; hands-on learning; high risk population; implementation strategy; improved; insight; intervention mapping; longitudinal analysis; macrovascular disease; medical schools; mobile application; mortality; pilot test; prevent; primary outcome; psychosocial; psychosocial wellbeing; skills; theories

PROJECT SUMMARY / ABSTRACT Type 1 diabetes (T1D) is one of the most common pediatric chronic conditions, affecting 187,000 children and adolescents in the United States. It is a complex and demanding condition that requires intensive self- management regimens to prevent complications. Despite improvements in diabetes technology to support self- management, nearly 85% of adolescents with T1D fail to meet recommended glycemic targets, putting them at risk for complications, reduced life expectancy, and diminished quality of life. Understanding and improving how adolescents are using advanced diabetes technology to perform self-management tasks in real-time can greatly improve the health of this high-risk population. The specific aims of the proposed research are: 1) Collect and integrate data streams from both continuous glucose monitoring (CGM) and ecological momentary assessment (EMA) to gain a new understanding of how adolescents use advanced diabetes technology in real time for self-management, and to identify potential intervention targets and strategies, 2) Design an ecological momentary intervention to improve self-management behaviors, 3) Pilot test the feasibility, acceptability, and potential efficacy of the new ecological momentary intervention to improve glycemic control. Upon completion, our team will prepare and submit an R01 proposal for a full-scale trial of the intervention to improve glycemic control and psychosocial outcomes. Candidate: Dr. DeJonckheere is an adolescent health services researcher and early career investigator focused on improving health outcomes for adolescents with T1D. Her career goal is to become an independent investigator with expertise in real-time assessment to develop theory- based interventions that optimize use of advanced diabetes technology for self-management. Building on her experience in educational research and adolescent engagement, this K01 award will support her to develop and evaluate self-management interventions to improve how adolescents with T1D use diabetes technology in everyday life. The specific aims are aligned with training aims in the career development plan: 1) develop expertise in real-time data collection through mobile applications to study how adolescents use advanced diabetes technology and data; 2) gain skills in the use of natural language processing techniques to rapidly analyze longitudinal, real-time qualitative data; 3) build skills in the development and testing of evidence- and theory-based intervention for adolescents with T1D; and 4) acquire knowledge in the biological processes and standards of care of T1D in adolescence. The career development plan will support Dr. DeJonckheere to achieve her training goals through dedicated mentorship by a team of leading investigators, advanced didactic coursework, execution of the proposed research plan, and participation in the broader scientific community. The University of Michigan, University of Michigan Medical School, and Department of Family Medicine provide strong institutional support and an excellent environment to complete the proposed career development award.

项目总结/摘要 1型糖尿病（T1 D）是最常见的儿科慢性疾病之一，影响187，000名儿童， 美国的青少年。这是一个复杂而苛刻的条件，需要密集的自我- 管理方案，以防止并发症。尽管糖尿病技术的进步，以支持自我- 在管理方面，近85%的T1 D青少年未能达到推荐的血糖目标， 并发症风险、预期寿命缩短和生活质量下降。理解和改善 青少年如何使用先进的糖尿病技术来实时执行自我管理任务， 极大地改善了这一高危人群的健康状况。建议研究的具体目标是：1） 收集并整合来自连续葡萄糖监测（CGM）和生态瞬时血糖监测（EMT）的数据流。 评估（EMA），以获得对青少年如何使用先进的糖尿病技术在真实的新的认识 自我管理的时间，并确定潜在的干预目标和策略，2）设计一个生态 3）初步测试自我管理行为的可行性、可接受性， 新的生态瞬时干预对改善血糖控制的潜在功效。完成后， 我们的团队将准备并提交一份R 01提案，以进行一项全面的干预试验， 控制和心理社会结果。候选人：DeJonckheere博士是一名青少年健康服务 研究人员和早期职业研究人员专注于改善T1 D青少年的健康结果。她 职业目标是成为一名独立的调查员，拥有实时评估的专业知识，以发展理论- 基于干预措施，优化使用先进的糖尿病自我管理技术。以她为基础 在教育研究和青少年参与的经验，这个K 01奖将支持她发展 评估自我管理干预措施，以改善T1 D青少年如何使用糖尿病技术， 日常生活具体目标与职业发展计划中的培训目标相一致：1）开发 通过移动的应用程序收集实时数据的专业知识，以研究青少年如何使用先进的 糖尿病技术和数据; 2）获得使用自然语言处理技术的技能， 分析纵向，实时定性数据; 3）建立证据开发和测试的技能-以及 对患有T1 D的青少年进行基于理论的干预;以及4）获得生物过程的知识， 青少年T1 D的护理标准。职业发展计划将支持DeJonckheere博士 通过由领先的研究人员团队提供的专业指导，先进的教学， 课程，执行拟议的研究计划，并参与更广泛的科学界。 密歇根大学、密歇根大学医学院和家庭医学系提供 强有力的机构支持和良好的环境，以完成拟议的职业发展奖。