Positive Psychology to Promote Adherence in Adolescents with Type 1 Diabetes

描述（由申请人提供）：1型糖尿病青少年患者的依从性问题很常见，发生率高达93%，并具有严重的健康后果，包括血糖控制欠佳和后期并发症的风险。然而，先前改善青少年1型糖尿病患者依从性的干预措施仅显示出适度至中等效果，而且许多干预措施耗时且昂贵。因此，需要新的干预措施来提高青少年1型糖尿病患者的依从性。增加积极影响（例如，感到快乐、愉快、自豪）已被证明可以促进成人对治疗建议的依从性。我们建议为1型糖尿病青少年制定、修订和试点积极心理干预措施，旨在增加依从性的动机。这种创新的干预将通过量身定制的感恩练习、自我肯定、小礼物和父母肯定来诱导青少年（13-17岁）的积极影响，以促进依从性。具体来说，我们的目标是增加血糖监测的频率，这是坚持治疗的最佳指标之一，与血糖控制密切相关。我们还将探索技术的使用，通过开发和比较电话管理和自动短信版本的干预，以确定哪种交付模式对青少年更有吸引力和更方便。该研究将由一个多学科团队进行，包括Sarah Jaser博士，儿科心理学家，和两个合作者，Robin Whittemore博士，APRN，护士研究员，和Stuart Weinzimer医学博士，儿科内分泌学家。我们相信这种低成本的积极心理学干预有可能增加青少年进行血糖监测的动机，而不会增加治疗管理的负担。该研究的结果将为该干预措施的大规模随机临床试验提供基础。

DESCRIPTION (provided by applicant): Problems with adherence in adolescents with type 1 diabetes are common - occurring at rates as high as 93% - and have serious health consequences, including suboptimal glycemic control and risk for later complications. Yet, previous interventions to improve adherence in adolescents with type 1 diabetes have only shown modest to moderate effects, and many have been time-intensive and expensive. Thus, there is a need for novel interventions to improve adherence in adolescents with type 1 diabetes. Increasing positive affect (e.g., feeling happy, cheerful, proud) has been shown to promote adherence to treatment recommendations in adult populations. We propose to develop, revise, and pilot test a positive psychology intervention for adolescents with type 1 diabetes aimed at increasing motivation for adherence. This innovative intervention would induce positive affect in adolescents (age 13-17) through tailored exercises in gratitude, self-affirmation, small gifts, and parent affirmations to promote adherence. Specifically, we aim to increase the frequency of blood glucose monitoring, which is one of the best indicators of adherence and is strongly linked to glycemic control. We will also explore the use of technology, by developing and comparing telephone-administered vs. automated text- messaging versions of the intervention, to determine which mode of delivery is more appealing and convenient for adolescents. The study will be conducted by a multidisciplinary team, consisting of Sarah Jaser, PhD, a pediatric psychologist, and two collaborators, Robin Whittemore, PhD, APRN, a nurse researcher, and Stuart Weinzimer, MD, a pediatric endocrinologist. We believe that this low-cost positive psychology intervention has the potential to increase adolescents' motivation for performing blood glucose monitoring without adding to the burden of treatment management. Results from the proposed study will provide the basis for a large scale randomized clinical trial of the intervention.