Identifying Stressors and Barriers to Accessing Care for Children with Type 1 Diabetes - Dr. Sara Davis is a pediatric clinical nurse specialist and associate professor in nursing at the University of South Alabama. This proposed K23 study will offer mentored research and career development experiences to support Dr. Davis’ long-term career goals of becoming a funded and productive independent clinical nurse scientist. Dr. Davis is committed to improving health outcomes in young children with type 1 diabetes (T1D). Despite having access to the medicine and supplies needed to manage T1D, many children still have trouble achieving and maintaining adequate blood sugar levels within the American Diabetes Association (ADA) recommended guidelines. There are several reasons blood sugar levels may be poorly controlled in children with diabetes. Social and structural factors may create additional stressors and barriers to identifying and accessing resources to manage the disease. Therefore, this project will engage children with T1D and their parents/caregivers as key stakeholders on an advisory board to inform a mixed methods action research (MMAR) study. The advisory board will help finalize the study protocol and ensure it is appropriate to identify, recruit, and engage children younger than 12 years old with T1D. Using information gleaned from the advisory board, a sequential (qual→QUAN) mixed methods design will be implemented to identify unique stressors and barriers to accessing and using community and healthcare resources in children ages 8-12 with T1D that may impact diabetes management. Semi-structured interviews with healthcare providers and community leaders will explore unique resources available to children and their families and ways to reduce barriers to accessing these resources. Following this, approximately 75 children with T1D and their parents/caregivers will complete surveys related to stressors and barriers and facilitators to using identified resources, all of which may impact daily diabetes management. Findings from the MMAR study will be used to adapt components of an intervention to decrease stress; facilitate access to resources; and improve daily diabetes management, glycemic levels, and health outcomes in children with T1D. To successfully complete the mentored research project, Dr. Davis will participate in training opportunities related to pediatric health outcomes, MMAR, clinical and behavioral interventional designs, and career development. She will also receive experiential training in randomized behavioral clinical trials under the direction of her mentor team. At the conclusion of this mentored K23 project, Dr. Davis will be in an ideal position to progress as an independent investigator focused on developing interventions to improve care and positive health outcomes for young children with T1D. Improving access to care and supportive resources could result in better glycemic levels thus reducing morbidities that may extend into adulthood.
