The professional development goal of this K01 award is to permit Dr. Rhodes, a pediatric endocrinologist with training in health services research, to develop expertise in research methods and disciplines that she will use to develop health promotion and disease prevention strategies for children with and at risk of Type 2 diabetes (T2DM). These methods and disciplines include assessment of health preferences, use of decision analysis, and health communication. Dr. Rhodes will achieve this goal through coursework, mentorship, and supervised research in collaboration with experts in pediatric obesity, pediatric diabetology, and decision science. This training will be a critical step in ensuring Dr. Rhodes' successful transition to an independent public health researcher. The scientific goal of this project is to evaluate the role of health preferences (values) in the treatment of T2DM in children. T2DM and its complications, though preventable, increasingly threaten youth, especially racial/ethnic minorities. Inadequate consideration of patients' health preferences in the design of clinical interventions may explain the apparent gap between the potential efficacy and actual effectiveness of these interventions. However, the preferences of children with T2DM for health states affected by their disease have not been described. Therefore, the aims of the research are: (1) To describe and compare the health preferences of adolescents with T2DM and their parents for key health states associated with T2DM using standard decision analytic methods, (2) to evaluate the association between child and parent concordance in ranking of preferences for T2DM-related health states and the child's glycemic control, (3) to evaluate the association of race/ethnicity with these preferences, and (4) to develop a decision analytic model of T2DM treatment in childhood that compares the long-term benefits of various treatment alternatives and that can determine whether recommended treatments are consistent with families' stated preferences. Dr. Rhodes proposes to conduct this research as an ancillary study to the TODAY study, an ongoing multicenter trial of treatments for T2DM in childhood. This importantresearch will assist Dr. Rhodes in advancing toward her long-term goal of improving the health and quality of life of children with and at risk of T2DM.
