Momentary Biobehavioral Effects on Physical Activity in Adults with T2 Diabetes

成人2型糖尿病患者的瞬时生物行为对体力活动的影响 摘要 独立之路奖的候选人是Cynthia Fritschi，博士，RN，她最近 在伊利诺伊大学芝加哥护理学院(UIC CON)完成博士学业。Dr。 Fritschi将由UIC Con的终身副教授Eileen Collins，博士，RN和 小爱德华·海因斯康复研究和发展的研究职业科学家。美国国务院 退伍军人事务部医院。该应用程序的目标是帮助Fritschi博士建立一个独立的程序 关于2型糖尿病患者体力活动的研究。在此提出的独立研究将 扩展我们对阻碍或促进身体健康的多层次生物、心理和社会因素的了解 活动行为。长期目标是帮助久坐不动的2型糖尿病成年人保持最佳状态 通过帮助他们增加身体活动行为来促进他们的健康和功能。这将会实现的 通过在自然环境中使用新颖的实时干预措施。候选人的短期职业目标 是获得必要的技能和经验，以开发与此相关的研究计划 重要的话题。 在她的研究《疲劳运动与糖尿病》(F31 NR009751)中，Fritschi博士担任博士前研究员 在横断面生物和自我报告数据收集方法和 多元回归分析。她探讨了一个重要的患者报告的结果(疲劳)及其 与女性2型糖尿病的相关性和影响。然而，这些研究的结果受到以下因素的限制 采用横断面设计，结合回想数据收集方法。现在，新奇的实时数据 采集方法，包括连续血糖监测(CGM)和活动监测仪(Actigraph) 与生态瞬时评估方法相结合，使有效地研究 生物行为因素与体力活动之间复杂的多层次关系。在她提议的K99中 指导研究，Fritschi博士将评估连续使用实时技术的可行性超过6 测量体力活动(手腕活动)、疲劳(自我报告)、血糖水平(CGM)的天数 相关的自我照顾行为(每晚日记)，以及其他相关因素的回顾测量 成年2型糖尿病患者的体力活动。可行性包括：(1)参与者的可接受性；(2)易用性 使用；(3)对日常活动的侵入性；(4)数据质量。可行性研究的结果将指导 修订独立研究并加强候选人学习必要的分析方法 实现她的短期和长期职业目标。 独立阶段(R00)的主要目标是使用最先进的生态瞬间 评估方法，以检查选定基线特征(健康/身体状况、 一般疲劳、身体成分、抑郁和人口因素)和实时生物行为因素 110例成人2型糖尿病患者的PA(疲劳和血糖水平)。通过生态瞬间 Fritschi博士和她的团队将评估与血糖水平和疲劳发作有关的体力活动 能够检查自然环境中的实时协变和时间关联。到目前为止，没有 另一项研究实时检查了2型糖尿病患者之间的这些关系。通过发现 他们的体力活动水平如何与疲劳和其他体力活动的生物行为决定因素相关， 这项研究的发现将指导针对增加体力活动的量身定制干预措施的发展 从而降低久坐不动的2型糖尿病成年人的残疾风险。 K99培训阶段的目标是加强Fritschi博士作为独立临床医生的能力 护士研究员。培训计划的第一个也是主要目标是增加弗里奇博士在实地的知识 以及运动能力、实时体力活动监测和运动行为的实验室测试。她会的 在纵向和干预性研究的设计和分析方面也得到指导。第二个培训目标是 提高使用生态瞬时评估数据收集方法和方法的知识和技能 分析，特别是与体育活动和相关健康行为有关的分析。

Momentary Biobehavioral Effects on Physical Activity in Adults with Type 2 Diabetes Abstract The candidate for this Pathway to Independence award is Cynthia Fritschi, PhD, RN, who recently completed her doctoral studies at the University of Illinois at Chicago College of Nursing (UIC CON). Dr. Fritschi will be mentored by Eileen Collins, PhD, RN, a tenured Associate Professor at the UIC CON and a Research Career Scientist in Rehabilitation Research and Development at the Edward Hines Jr. Department of Veterans Affairs Hospital. The goal of this application is to assist Dr. Fritschi to build an independent program of research in physical activity for people with type 2 diabetes. The independent research proposed herein will expand our knowledge of multilevel biological, psychological, and social factors that impede or foster physical activity behavior. The long-term goal is to assist sedentary adults with type 2 diabetes to maintain optimal health and functioning by helping them to increase physical activity behaviors. This will be accomplished through use of novel, real-time interventions in the natural environment. The candidate's short-term career goal is to acquire the skills and experience necessary to develop a program of research related to this very important topic. In her study, "Fatigue Exercise, and Diabetes" (F31 NR009751) as a predoctoral fellow, Dr. Fritschi developed extensive experience in cross-sectional biological and self-report data collection methods and multivariate regression analyses. She explored an important patient-reported outcome (fatigue) and its correlates and impact on women with type 2 diabetes. However, findings from these studies were limited by use of a cross-sectional design in combination with recall data collection methods. Now, novel, real-time data collection methods, including continuous glucose monitoring (CGM) and activity monitors (actigraphy) in combination with ecological momentary assessment methods have made it possible to effectively study the complex multilevel relationships between biobehavioral factors and physical activity. In her proposed K99 mentored research, Dr. Fritschi will evaluate the feasibility of using real-time technology continuously over 6 days to measure physical activity (wrist actigraphy), fatigue (self-report), blood glucose levels (CGM), and related self-care behaviors (nightly diary), alongside retrospective measures of other factors associated with physical activity in adults with type 2 diabetes. Feasibility includes: (1) acceptability to participants; (2) ease of use; (3) invasiveness into daily activities; and (4) data quality. Findings from the feasibility study will guide revision of the independent research and enhance candidate learning of the analytical methods necessary to achieve her short- and long-term career goals. The primary aim of the independent phase (R00) is to use state-of-the-science ecological momentary assessment methods to examine the influence of selected baseline characteristics (health/physical status, general fatigue, body composition, depression, and demographic factors) and real-time biobehavioral factors (fatigue and blood glucose levels) on PA in 110 adults with type 2 diabetes. Through ecological momentary assessment of physical activity in relation to glucose levels and fatigue episodes, Dr. Fritschi and her team will be able to examine real-time covariation and temporal associations in the natural environment. To date, no other study has examined these relationships in real time among people with type 2 diabetes. By discovering how their physical activity levels relate to fatigue and other biobehavioral determinants of physical activity, findings from this study will guide development of tailored interventions targeted at increasing physical activity and thus reducing the risks for disability in sedentary adults with type 2 diabetes. The goal of the K99 training phase is to strengthen Dr. Fritschi's ability to excel as an independent clinical nurse researcher. The first and primary goal of the training plan is to increase Dr. Fritschi's knowledge in field and laboratory tests of exercise capacity, real-time physical activity monitoring, and exercise behavior. She will also be mentored in longitudinal and intervention research design and analysis. The second training goal is to advance her knowledge and skills in the use of ecological momentary assessment data collection methods and analysis, especially related to physical activity and related health behaviors.