The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to understand the development of health communication competence in adolescents and young adults (AYAs) with type 1 diabetes (T1D) and evaluate associations among health communication, self-care, and health outcomes in this population. AYAs with T1D are at high risk for negative health outcomes, including poor glycemic control, increased chronic complications, and poor quality of life. The deterioration of glycemic control occurs in parallel with the assumption of independent self-care skills, including responsibility fo medical care. Effective communication between AYAs and health care providers may be a critical, yet understudied, contributor to self-care skills. The proposed longitudinal study plans o examine the development of health communication skills in 75 adolescents and young adults (ages 16-20) with T1D over an 18 month period and evaluate high- quality health communication as a predictor of diabetes self-care and health outcomes. The candidate's long term goal is to develop and implement innovative preventive interventions to best prepare AYAs with chronic illnesses and their families for transition to independent self-care. Specific short-term training goals proposed for this award include: 1) Develop expertise in the assessment and evaluation of health communication in AYAs;2) Expand knowledge of pathophysiology of T1D;and 3) Gain advanced behavioral science competencies, including advanced data analyses, clinical trial design, and grant writing. The research and training experiences proposed within this 4-year K23 award will be conducted at Children's National Medical Center and Johns Hopkins University and are supported by an outstanding multidisciplinary team of mentors and advisors, including Dr. Randi Streisand (Primary Mentor), Dr. Pamela Hinds (Co-Mentor), and Dr. Kristin Riekert (Co-Mentor). This focused mentorship and training will position the candidate to become a successful independent investigator in behavioral diabetes research. Results from this study have the potential to greatly improve self-care skills and reduce negative health outcomes in AYAs with T1D. Equipping adolescents and young adults with skills to enhance health communication may hasten the development of vital self-advocacy skills needed for independent self-care and in the adult health care system and, thus, establish a lasting pattern of positive health interactions.

Public Health Relevance

Adolescents and young adults (AYAs) with T1D are at significant risk for poor self-care and negative health outcomes as they assume independent responsibility for disease management. The proposed research and training plan evaluates the context and content of AYA communication with health care providers and associations among health communication quality, self-care, and health outcomes. Achievement of the study aims will inform a targeted, communication-based intervention to improve self-care, and ultimately positively impact health outcomes, in AYAs with T1D.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Mentored Patient-Oriented Research Career Development Award (K23)
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Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
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Hyde, James F
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Children's Research Institute
United States
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Majumder, Elora; Cogen, Fran R; Monaghan, Maureen (2017) Self-Management Strategies in Emerging Adults With Type 1 Diabetes. J Pediatr Health Care 31:29-36
Devine, Katie A; Monaghan, Maureen; Schwartz, Lisa A (2017) Introduction to the Special Issue on Adolescent and Young Adult Health: Why We Care, How Far We Have Come, and Where We Are Going. J Pediatr Psychol 42:903-909
Tully, Carrie; Shneider, Caitlin; Monaghan, Maureen et al. (2017) Peer Coaching Interventions for Parents of Children with Type 1 Diabetes. Curr Diab Rep 17:39
Monaghan, Maureen; Baumann, Katherine (2016) Type 1 diabetes: addressing the transition from pediatric to adult-oriented health care. Res Rep Endocr Disord 6:31-40
Monaghan, Maureen; King, Megan McCormick; Alvarez, Vanessa et al. (2016) Changes in type 1 diabetes health indicators from high school to college. J Am Coll Health 64:157-61
Monaghan, Maureen; Clary, Lauren; Stern, Alexa et al. (2015) Protective Factors in Young Children With Type 1 Diabetes. J Pediatr Psychol 40:878-87
Monaghan, Maureen; Helgeson, Vicki; Wiebe, Deborah (2015) Type 1 diabetes in young adulthood. Curr Diabetes Rev 11:239-50
Monaghan, Maureen; Herbert, Linda Jones; Wang, Jichuan et al. (2015) Mealtime behavior and diabetes-specific parent functioning in young children with type 1 diabetes. Health Psychol 34:794-801
Monaghan, Maureen; Clary, Lauren; Mehta, Priya et al. (2015) Checking In: A Pilot of a Physician-Delivered Intervention to Increase Parent-Adolescent Communication About Blood Glucose Monitoring. Clin Pediatr (Phila) 54:1346-53
Gray, Wendy N; Monaghan, Maureen C; Gilleland Marchak, Jordan et al. (2015) Psychologists and the Transition From Pediatrics to Adult Health Care. J Adolesc Health 57:468-74

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