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Uptake of Evidence-Based Behavioral Intervention for Pediatric Type 1 Diabetes

Award Number: K23DK125666
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/15/2020
PERIOD OF PERFORMANCE END DATE: 04/30/2026

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Uptake of Evidence-Based Behavioral Intervention for Pediatric Type 1 Diabetes - PROJECT SUMMARY/ABSTRACT Type 1 diabetes (T1D) is one of the most prevalent pediatric chronic illnesses and requires a complex treatment regimen. Youth with T1D, particularly those from ethnic minority and lower income backgrounds, struggle to adhere to treatment demands; fewer than 30% achieve recommended levels of glycemic control. Youth with poorly controlled T1D are at risk for health complications. Behavioral Family Systems Therapy for Diabetes (BFST-D), a family-based behavioral intervention, is efficacious in improving health outcomes for youth with T1D and initial effectiveness data suggest a brief version of BFST-D (bBFST-D) is associated with improved glycemic control when delivered as part of standard care. However, few receive these services, particularly those most at-risk, which complicates further evaluation of bBFST-D effectiveness when delivered as part of standard care. Increasing the uptake of bBFST-D may lead to improved overall health of this population. Implementation strategies are methods for integrating evidence-based practices into standard care. The proposed K23 career development award aims to address these gaps in research and provides the means by which Dr. Julia Price will complete scholarly training and practical experience to become an independent investigator in pediatric T1D. The proposed study will develop a toolkit of implementation strategies to increase the reach of bBFST-D by first conducting qualitative interviews with stakeholder groups to identify barriers and facilitators of this care (Aim 1). The Consolidated Framework for Implementation Research (CFIR) will guide these interviews. Second, using results from Aim 1 and drawing from literature identifying conceptually unique implementation strategies, a toolkit of implementation strategies will be developed (Aim 2). Iterative feedback from a Diabetes Advisory Board comprised of stakeholders will facilitate this development process and support identification of three implementation strategies to pilot. Third, the feasibility and acceptability of the selected strategies will be evaluated through a single-case experiment at the PIs institution, and exploratory outcomes (effectiveness of these strategies, change in patient health outcomes among those attending bBFST-D as part of standard care) will also be examined (Aim 3). To explore potential healthcare disparities, provider referral patterns across youth demographic variables will be examined. Through a combination of formal didactics and direct mentored training experiences with her mentoring team (Drs. Kazak, Deatrick, Haire-Joshu, Bunnell, Wysocki), Dr. Price will acquire skills and expertise in the following areas: 1) mixed methods research, 2) implementation science, 3) optimizing electronic health record use for research and for implementing evidence- based healthcare, and 4) designing and conducting clinical trials. Nemours, a national leader in pediatric T1D behavioral research and health informatics, will provide Dr. Price with the ideal environment to successfully complete the proposed project and achieve her goals of becoming an independent investigator and applying for R01 funding to conduct a large multisite randomized hybrid implementation-effectiveness trial of bBFST-D.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $137,351 )
2024	2024	THE NEMOURS FOUNDATION	1600 ROCKLAND RD	WILMINGTON	DE	19803	NEW CASTLE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	4/30/2024	NON-COMPETING CONTINUATION	$137,351
														Subtotal = $137,351

Issue Date FY: 2023 ( Subtotal = $140,539 )
2023	2023	THE NEMOURS FOUNDATION	1600 ROCKLAND RD	WILMINGTON	DE	19803	NEW CASTLE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	4/6/2023	NON-COMPETING CONTINUATION	$140,539
														Subtotal = $140,539

Issue Date FY: 2022 ( Subtotal = $143,339 )
2022	2022	NEMOURS FOUNDATION, THE	1600 ROCKLAND RD	WILMINGTON	DE	19803	NEW CASTLE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	4/28/2022	NON-COMPETING CONTINUATION	$143,339
														Subtotal = $143,339

Issue Date FY: 2021 ( Subtotal = $145,295 )
2021	2021	NEMOURS FOUNDATION, THE	1600 ROCKLAND RD	WILMINGTON	DE	19803	NEW CASTLE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	5/6/2021	NON-COMPETING CONTINUATION	$145,295
														Subtotal = $145,295

Issue Date FY: 2020 ( Subtotal = $147,367 )
2020	2020	NEMOURS FOUNDATION, THE	1600 ROCKLAND RD	WILMINGTON	DE	19803	NEW CASTLE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	7/2/2020	NEW	$147,367
														Subtotal = $147,367

Grand Total All Awards = $713,891

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Uptake of Evidence-Based Behavioral Intervention for Pediatric Type 1 Diabetes

Award Number: K23DK125666

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/15/2020

PERIOD OF PERFORMANCE END DATE: 04/30/2026

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