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

项目摘要/摘要 1型糖尿病(T1D)是最常见的儿科慢性疾病之一，影响187,000名儿童和 美国的青少年。这是一种复杂而苛刻的情况，需要强烈的自我 预防并发症的管理方案。尽管糖尿病技术有所改进，以支持自我 管理方面，近85%的患有T1D的青少年未能达到推荐的血糖目标，使他们处于 有并发症的风险，预期寿命缩短，生活质量下降。理解和改进 青少年如何使用先进的糖尿病技术实时执行自我管理任务 大大改善这一高危人群的健康。拟议研究的具体目标是：1) 收集和整合来自连续血糖监测(CGM)和生态瞬时监测的数据流 评估(EMA)以获得对青少年如何实际使用先进糖尿病技术的新理解 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 短期干预以改善自我管理行为，3)试点测试可行性、可接受性和 新的生态瞬时干预改善血糖控制的潜在效果。完成后， 我们的团队将准备并提交一份R01提案，对改善血糖的干预进行全面试验 控制和心理社会结果。应聘者：德容克希尔博士是一名青少年健康服务人员 研究人员和早期职业调查员专注于改善患有T1D的青少年的健康结果。她 职业目标是成为一名独立的调查员，拥有实时评估方面的专业知识，以开发理论- 基于干预措施，优化使用先进的糖尿病技术进行自我管理。建立在她的基础上 在教育研究和青少年参与方面的经验，这个K01奖将支持她的发展 并评估自我管理干预措施，以改善患有T1D的青少年在 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)发展 通过移动应用程序收集实时数据以研究青少年如何使用高级 糖尿病技术和数据；2)掌握运用自然语言处理技术快速 分析纵向、实时的定性数据；3)建立证据开发和测试方面的技能-以及 对患有T1D的青少年进行以理论为基础的干预；4)在生物过程中获得知识，并 青春期T1D照护标准。职业发展计划将支持德容克希尔博士 通过一组领先的调查人员、高级教学人员的专心指导，实现她的培训目标 课程工作，执行拟议的研究计划，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 强大的制度支持和良好的环境，以完成拟议的职业发展奖。

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.