Type 2 diabetes (T2DM) is recognized as a growing problem among adolescents, particularly in minority populations. While T2DM previously represented less than 5% of new diabetes diagnoses in pediatrics, it now accounts for as much as 50% of new diagnoses. The treatment of T2DM in adolescents requires comprehensive care that includes behavioral and pharmacologic interventions. Studies show that approximately 50% of adolescents with chronic problems do not comply with care recommendations. This non-adherence can be exacerbated by patient, provider and system attributes. Addressing patient, provider and system barriers to care are crucial in the development of a successful comprehensive program for the treatment of T2DM in adolescents. This proposal will advance current knowledge about T2DM in adolescents through emphasis on identifying barriers to care, and applying this information to the development and evaluation of a comprehensive intervention to improve adolescent diabetes care. To accomplish these goals I will work with Dr. Robert Dittus, Director of the Vanderbilt Center for Health Services Research, Dr. William Russell, Division Chief of Pediatric Endocrinology, and Dr. David Schlundt, Co-director of the Behavioral Core of the Vanderbilt Diabetes Research and Training Center (DRTC) to further my career development in (1) adolescent diabetes, (2) methods for identifying and measuring psychosocial determinants of adolescent behavior, and (3) designing and evaluating interventions to improve self-management behaviors and treatment adherence in adolescents with T2DM.
The specific aims of this research will be to: (1) perform surveys and focus groups to identify patient/parent barriers to care for adolescents with T2DM and strategies for addressing these barriers (2) examine provider and system barriers to proper management of adolescent T2DM, and (3) to use this information to develop and implement a randomized controlled trial of a new comprehensive diabetes management program for adolescents with T2DM. The process and results of this research will provide valuable insights into adolescent diabetes, and will accelerate my future independent investigation in adolescent T2D.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK065294-02
Application #
7091470
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Hyde, James F
Project Start
2005-07-05
Project End
2010-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
2
Fiscal Year
2006
Total Cost
$124,490
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Mulvaney, Shelagh A; Lilley, Jessica S; Cavanaugh, Kerri L et al. (2013) Validation of the diabetes numeracy test with adolescents with type 1 diabetes. J Health Commun 18:795-804
White 3rd, Richard O; Osborn, Chandra Y; Gebretsadik, Tebeb et al. (2011) Development and validation of a Spanish diabetes-specific numeracy measure: DNT-15 Latino. Diabetes Technol Ther 13:893-8
Ciampa, Philip J; Kumar, Disha; Barkin, Shari L et al. (2010) Interventions aimed at decreasing obesity in children younger than 2 years: a systematic review. Arch Pediatr Adolesc Med 164:1098-104
Osborn, Chandra Y; Cavanaugh, Kerri; Wallston, Kenneth A et al. (2010) Self-efficacy links health literacy and numeracy to glycemic control. J Health Commun 15 Suppl 2:146-58
Cherrington, Andrea; Wallston, Kenneth A; Rothman, Russell L (2010) Exploring the relationship between diabetes self-efficacy, depressive symptoms, and glycemic control among men and women with type 2 diabetes. J Behav Med 33:81-9
Kumar, Disha; Sanders, Lee; Perrin, Eliana M et al. (2010) Parental understanding of infant health information: health literacy, numeracy, and the Parental Health Literacy Activities Test (PHLAT). Acad Pediatr 10:309-16
Ciampa, Philip J; Osborn, Chandra Y; Peterson, Neeraja B et al. (2010) Patient numeracy, perceptions of provider communication, and colorectal cancer screening utilization. J Health Commun 15 Suppl 3:157-68
Wong, Kam; Potter, Amy; Mulvaney, Shelagh et al. (2010) Pediatric endocrinologists' management of children with type 2 diabetes. Diabetes Care 33:512-4
Cavanaugh, Kerri L; Wingard, Rebecca L; Hakim, Raymond M et al. (2010) Low health literacy associates with increased mortality in ESRD. J Am Soc Nephrol 21:1979-85
Osborn, Chandra Y; Cavanaugh, Kerri; Wallston, Kenneth A et al. (2009) Diabetes numeracy: an overlooked factor in understanding racial disparities in glycemic control. Diabetes Care 32:1614-9

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