Research Center for Health Equity, Cedars-Sinai Medical Center, United States of America.
Keck School of Medicine, University of Southern California, United States of America.
Contemp Clin Trials. 2020 Aug;95:106079. doi: 10.1016/j.cct.2020.106079. Epub 2020 Jul 4.
Adolescent and young adults (AYA) with Type 1 Diabetes (T1D) experience more difficulty with glycemic control than patients in all other age groups. The shared medical appointment (SMA) model has been effective in multiple healthcare populations, but the feasibility and effectiveness of SMA in AYA patients with T1D is unclear.
This research leverages the team's multidisciplinary expertise to develop an engaging intervention toolkit and test the implementation of the Team Clinic care model for the treatment of T1D among middle school adolescents in a large urban children's hospital serving an economically, racially and ethnically diverse population. In Phase 1, the team will manualize the Team Clinic care model into an engaging, age-appropriate educational and intervention toolkit. In Phase 2, the team will conduct a randomized clinical trial to test the feasibility and usability of the toolkit from the provider perspective (team member satisfaction; clinical efficiency; compliance with American Diabetes Association, American Association of Diabetes Educators, and California Children's Services standards; and payor-level cost data) and the preliminary efficacy of the intervention toolkit on patient- and family-level outcomes (attendance, acceptability/satisfaction with care, patient-level cost data, diabetes outcomes, diabetes family conflict, diabetes distress, and depression).
AYA patients with T1D often receive care in clinics and institutions with limited resources and time. This research tests the feasibility and efficacy of an innovative and potentially cost-effective SMA model to address the unique needs of underserved populations, while meeting national and state clinical standards. Trial registration The study is registered with ClinicalTrials.gov (Protocol Record: NCT04190368).
青少年和年轻成年人（AYA）的 1 型糖尿病（T1D）比所有其他年龄段的患者更难以控制血糖。共享医疗预约（SMA）模式已在多个医疗保健人群中有效，但 SMA 在 T1D 的 AYA 患者中的可行性和有效性尚不清楚。
本研究利用团队的多学科专业知识，开发一个引人入胜的干预工具包，并测试在为服务于经济、种族和族裔多样化人群的大型城市儿童医院的中学生中实施 Team Clinic 治疗 T1D 的护理模式。在第 1 阶段，团队将把 Team Clinic 护理模式手动转化为一个引人入胜、适合年龄的教育和干预工具包。在第 2 阶段，团队将进行一项随机临床试验，从提供者的角度（团队成员满意度；临床效率；遵守美国糖尿病协会、美国糖尿病教育者协会和加利福尼亚儿童服务标准；以及支付方层面的成本数据）以及从患者和家庭层面的结果（出勤率、对护理的接受度/满意度、患者层面的成本数据、糖尿病结果、糖尿病家庭冲突、糖尿病困扰和抑郁）测试工具包的可行性和初步疗效。
患有 T1D 的 AYA 患者通常在资源和时间有限的诊所和机构中接受治疗。这项研究测试了一种创新且潜在具有成本效益的 SMA 模式的可行性和疗效，以满足服务不足人群的独特需求，同时满足国家和州的临床标准。试验注册 该研究在 ClinicalTrials.gov 上注册（方案记录：NCT04190368）。
