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携手改善糖尿病:一项针对向成人护理过渡的 1 型糖尿病青年成人的基于优势的同伴指导干预临床试验方案。

DiaBetter Together: Clinical trial protocol for a strengths-based Peer Mentor intervention for young adults with type 1 diabetes transitioning to adult care.

作者信息

Carreon Samantha A, Minard Charles G, Lyons Sarah K, Levy Wendy, Camey Stephanie, Desai Kishan, Duran Brenda, Streisand Randi, Anderson Barbara J, McKay Siripoom V, Tang Tricia S, Devaraj Sridevi, Ramphul Ryan, Hilliard Marisa E

机构信息

Texas Children's Hospital, Houston, TX, United States of America; Baylor College of Medicine, Houston, TX, United States of America.

Baylor College of Medicine, Houston, TX, United States of America.

出版信息

Contemp Clin Trials. 2024 Dec;147:107713. doi: 10.1016/j.cct.2024.107713. Epub 2024 Oct 10.

Abstract

BACKGROUND

Type 1 diabetes (T1D) management is challenging for young adults, who are expected to transfer from the pediatric to adult T1D healthcare system while also managing typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended gaps in care before following up in adult care, increasing risk for poor health outcomes. There are few evidence-based programs to support young adults with T1D to promote a timelier transition during this period. This paper reports on the design of DiaBetter Together, a randomized controlled trial to evaluate a 12-month Peer Mentor-delivered intervention compared to usual care among young adults with T1D during the transfer from pediatric to adult care.

METHODS

One-hundred young adults (age 17-25) with T1D and 29 Peer Mentors enrolled in this randomized clinical trial. Peer Mentors are experienced, older young adults with T1D, trained by the study team to share transition experiences and strategies to successfully navigate the adult healthcare system, help young adults prepare for the first adult care visit, and use strengths-based support strategies to teach and model skills for managing T1D-related challenges.

RESULTS

The primary outcome of the trial is HbA1c, and secondary outcomes include time to adult care, engagement in diabetes self-management behaviors, and psychosocial well-being.

CONCLUSION

The goal of this research is to evaluate a developmentally appropriate, supportive intervention that can improve T1D self-management and successful transfer of care during the difficult young adult years and promote optimal T1D health outcomes.

摘要

背景

1型糖尿病(T1D)的管理对年轻人来说具有挑战性,他们需要从儿科T1D医疗保健系统过渡到成人T1D医疗保健系统,同时还要应对典型的发育需求(如社交、财务、工作/学业、居住等)。许多年轻人在接受成人护理之前,护理间隔时间较长,这增加了健康状况不佳的风险。几乎没有基于证据的项目来支持患有T1D的年轻人在这一时期促进更及时的过渡。本文报告了“携手共筑更好糖尿病”(DiaBetter Together)的设计,这是一项随机对照试验,旨在评估在从儿科护理向成人护理过渡期间,与常规护理相比,由同伴导师提供的为期12个月的干预措施对患有T1D的年轻人的效果。

方法

100名患有T1D的年轻人(年龄17 - 25岁)和29名同伴导师参与了这项随机临床试验。同伴导师是有经验的、年龄较大的患有T1D的年轻人,由研究团队培训,分享过渡经验和成功融入成人医疗保健系统的策略,帮助年轻人为首次成人护理就诊做好准备,并使用基于优势的支持策略来教授和示范应对与T1D相关挑战的技能。

结果

该试验的主要结局指标是糖化血红蛋白(HbA1c),次要结局指标包括接受成人护理的时间、参与糖尿病自我管理行为的情况以及心理社会幸福感。

结论

本研究的目的是评估一种适合年轻人发育阶段的支持性干预措施,该措施可以改善T1D的自我管理,在年轻人困难时期实现护理的成功过渡,并促进T1D的最佳健康结局。

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