Identifying Best Practices of Diabetes Self-Management: A Mixed Methods Approach

描述(申请人提供)：糖尿病是一个日益严重的公共卫生问题。虽然我们知道改变生活方式，如适当的饮食、锻炼、药物治疗和血糖测试可以有效地改善血糖控制，但对于成功维持A1c的患者是如何在日常生活中实施特定策略的，我们知之甚少。这个假设是，有效的糖尿病自我管理实践可以通过定性研究来确定，以研究那些已经成功的个人，并可以用于医疗干预。这项建议的目的是：(1)通过定性研究(深度访谈、期刊)确定与成功的血糖控制相关的2型糖尿病患者的自我管理做法；(2)开发和优化成功做法的调查；以及(3)在对2型糖尿病患者的横断面研究中验证调查结果。这份K01提案的职业目标是成为一名独立的调查员，专门从事行为健康和慢性疾病(如糖尿病)的定性研究。这项提议是新颖的，因为没有使用来自成功的糖尿病患者的严格定性方法来开发自我管理实践的调查，也没有使用关于如何将这些实践实施到2型糖尿病患者的日常生活中的综合数据库来创建。 与公共健康相关：在美国，糖尿病至少影响2360万成年人，尽管有循证指南，但大多数人的血糖仍未得到控制(A1c&GT；7.0，ADA)。不良的自我管理导致不良的血糖控制；然而，关于特定的患者自我护理实践与血糖控制的关系的信息很少。确定有助于A1C成功的做法可能会对控制糖尿病流行产生重大的公共卫生影响，并改进推动该领域的糖尿病治疗。

DESCRIPTION (provided by applicant): Diabetes is a growing public health concern. Although we know that lifestyle modifications such as proper diet, exercise, medication, and glucose testing are effective in improving glycemic control, there is little known about how patients who have been successful at maintaining A1c have implemented specific strategies in everyday life. The hypothesis is that effective diabetes self-management practices can be identified using qualitative research to study individuals who have been successful, and can be used in healthcare interventions. The aims of this proposal are: (1) identify the self-management practices of people with type 2 diabetes that are associated with successful glucose control (A1c <=7) through qualitative research (in- depth interviews, journals); (2) develop and optimize a survey of successful practices; and (3) validate the survey in a cross-sectional study with type 2 diabetes patients. The career objective of this K01 proposal is to become an independent investigator who specializes in qualitative research within behavioral health and chronic illnesses, such as diabetes. The proposal is novel because no survey of self-management practices has been developed using rigorous qualitative methods from successful diabetes patients, nor created using a comprehensive database of how those practices could be implemented into everyday life for those with type 2 diabetes. PUBLIC HEALTH RELEVANCE: Diabetes affects at least 23.6 million adults in the US and, despite evidence-based guidelines, the majority still have uncontrolled blood glucose (A1c > 7.0, ADA). Poor self-management leads to poor glucose control; however, there is little information about the relationship of specific patient self-care practices to glycemic control. Determining the practices that contribute to A1c success could have a substantial public health impact on managing the diabetes epidemic and improve the treatment of diabetes that drive the field.