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.

项目摘要 /摘要 1型糖尿病（T1D）是最常见的儿科慢性病之一，影响了187,000名儿童和 美国的青少年。这是一个复杂且苛刻的条件，需要密集的自我 管理方案以防止并发症。尽管糖尿病技术有所改善以支持自我 管理层，将近85％的T1D青少年无法实现推荐的血糖靶标，将其置于 并发症的风险，预期寿命降低以及生活质量下降。理解和改进 青少年如何使用高级糖尿病技术实时执行自我管理任务 大大改善了这种高风险人口的健康。拟议研究的具体目的是：1） 从连续葡萄糖监测（CGM）和生态瞬间收集和整合数据流 评估（EMA），以对青少年如何在真实中使用晚期糖尿病技术有了新的了解 自我管理的时间并确定潜在的干预目标和策略，2）设计生态学 暂时的干预以改善自我管理行为，3）试验测试可行性，可接受性和 新的生态瞬时干预措施的潜在功效以改善血糖控制。完成后， 我们的团队将准备并提交R01提案，以进行全面试验，以改善血糖 控制和社会心理成果。候选人：Dejonckheere博士是青少年卫生服务 研究人员和早期职业研究者致力于改善T1D青少年的健康成果。她 职业目标是成为具有实时评估专业知识的独立研究者，以发展理论 - 基于优化高级糖尿病技术进行自我管理的干预措施。建立在她身上 在教育研究和青少年参与方面的经验，该K01奖将支持她发展 并评估自我管理干预措施，以改善与T1D的青少年使用糖尿病技术 日常生活。具体目标与职业发展计划中的培训目标保持一致：1） 通过移动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高级 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）在证据和测试中建立技能 - 基于理论的T1D青少年的干预； 4）在生物过程中获取知识 青春期T1D的护理标准。职业发展计划将支持Dejonckheere博士 通过一组领先的调查员团队，高级教学法来实现她的培训目标 课程工作，拟议的研究计划的执行以及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 强大的机构支持和填写拟议职业发展奖的绝佳环境。