Document text
Principal Investigator: INGRID M LIBMAN
Organization: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
Fiscal Year: 2024
Award: $251,488
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
Abstract
Diabetes self-management education and support (DSMES) is considered a cornerstone of care and essential
in helping people navigate self-management decisions and activities. Despite evidence that DSMES is a critical
component of diabetes care, participation remains low. Emerging adulthood (EA) has been described as the
distinct period between 18 and 25 years when adolescents work to achieve autonomy and explore life
possibilities in moving toward adulthood. Suboptimal self-management has been identified as a major problem
in EAs with type 1 diabetes (T1D), a particularly vulnerable group with an increased risk for poor diabetes-related
outcomes. In its current form DSMES has been cited for not meeting the needs of EAs, when EAs have
expressed interest in DSMES delivered with peer-supported, technological and applied learning-driven methods.
To address these challenges, we are applying information gained from the literature and key stakeholders to our
established Telemedicine for Reach, Education, Access and Treatment (TREAT) delivery model with a specific
focus on DSMES. TREAT-ED (for self-management EDucation) will be designed to specifically engage EAs in
DSMES by integrating DSMES objectives to support informed decision making, self-care, and preparation for
transfer to adult care, to improve outcomes. Diabetes care and education specialists (DCESs) will lead TREAT-
ED with a cohort of EAs and will 1) help to organize and facilitate group sessions delivered through telehealth
and 2) use continuous blood glucose monitoring (CGM) reports as personalized examples to drive established
DSMES content. With user-centered design techniques, we will evaluate implementation determinants and then
develop, build, and test the TREAT-ED model. Feasibility assessment of the impact of the model on EA patient
participation in DSMES along with clinical, psychosocial and behavioral outcomes will be examined. We
hypothesize that models that rely on current day strategies to engage EAs at high risk for diabetes-related
problems with effective self-management skills will improve DSMES engagement and outcomes. If proven to be
effective, this model is one that could be adapted for EAs who have transferred to adult diabetes care and other
patient populations throughout the US.
Terms: <21+ years old><Address><Adolescent><Adolescent Youth><Adult><Adult Human><Affect><Application Context><Assess implementation><Behavior><Behavioral><Brittle Diabetes Mellitus><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Caring><Clinic><Clinical><Continuous Glucose Monitor><Control Groups><Data><Decision Making><Development><Devices><Diabetes Mellitus><Education><Educational aspects><Effectiveness><Ensure><Exhibits><Feasibility Studies><Future><Goals><IDDM><Implementation assessment><Insulin-Dependent Diabetes Mellitus><Intervention><Intervention Strategies><Interview><Juvenile-Onset Diabetes Mellitus><Ketosis-Prone Diabetes Mellitus><Lead><Life><Literature><Methods><Modeling><Monitor><Outcome><Parents><Patient Monitoring><Patient Participation><Patients><Pb element><Persons><Preparation><Problem Solving><Provider><Reporting><Research><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Self Care><Self Management><Series><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Specialist><Sudden-Onset Diabetes Mellitus><T1 DM><T1 diabetes><T1D><T1DM><Techniques><Technology><Telemedicine><Testing><Time><Type 1 Diabetes Mellitus><Type 1 diabetes><Type I Diabetes Mellitus><Visit><Vulnerable Populations><Work><Youth><Youth 10-21><adulthood><age group><applied learning><behavior outcome><behavioral outcome><clinical practice><cohort><collaborative approach><contextual factors><continuous blood glucose monitor><continuous blood sugar monitor><continuous glucose measurement><continuous sugar monitor><coping><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><design><design,build,test><designing><developmental><diabetes><diabetes risk><diabetes self-care><diabetes self-management><early adulthood><effectiveness measure><effectiveness/implementation hybrid study><effectiveness/implementation study><emerging adult><emerging adulthood><evaluate implementation><evaluation of implementation><experience><hands-on learning><heavy metal Pb><heavy metal lead><high risk><implementation determinants><implementation evaluation><implementation factors><implementation outcomes><implementation strategy><improved><improved outcome><insulin dependent diabetes><insulin dependent type 1><interactive engagement><interactive learning><interest><intervention design><interventional strategy><juvenile><juvenile diabetes><juvenile diabetes mellitus><juvenile human><ketosis prone diabetes><new approaches><novel><novel approaches><novel strategies><novel strategy><parent><patient population><peer support><personal care><pilot test><pilot trial><pragmatic effectiveness trial><pragmatic trial><preparations><primary outcome><programs><prototype><psychosocial><psychosocial outcome><psychosocial sequelae><response><satisfaction><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><strategies for implementation><telehealth><therapy design><treatment design><type I diabetes><type one diabetes><uptake><user centered design><vulnerable group><vulnerable individual><vulnerable people>