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

描述（由申请人提供）：糖尿病是一个日益严重的公共卫生问题。虽然我们知道生活方式的改变，如适当的饮食，运动，药物治疗和血糖检测是有效的改善血糖控制，但很少有人知道那些成功维持A1 c的患者如何在日常生活中实施特定的策略。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，以研究成功的个体，并可用于医疗干预。本提案的目的是：（1）通过定性研究（深入访谈、期刊）确定与成功血糖控制（A1 c <=7）相关的2型糖尿病患者的自我管理实践;（2）开发和优化成功实践的调查;（3）在2型糖尿病患者的横断面研究中验证调查。这个K 01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。该提案是新颖的，因为没有使用严格的定性方法对成功的糖尿病患者进行自我管理实践的调查，也没有使用综合数据库创建这些实践如何在2型糖尿病患者的日常生活中实施。 公共卫生相关性：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不受控制（A1 c> 7.0，ADA）。不良的自我管理导致血糖控制不良;然而，关于特定患者自我护理实践与血糖控制之间的关系的信息很少。确定有助于A1 c成功的实践可能对管理糖尿病流行病产生重大的公共卫生影响，并改善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.