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

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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.