The proposed career development application for Jessica Markowitz, Ph.D. will take place with the guidance of a strong mentoring team in an academic center, both with established track records of providing career development and trajectories toward independent investigation. Throughout the five year period, career development activities will occur, including meetings with mentors and collaborators, relevant coursework, human subjects training, attendance at relevant lectures, and manuscript development, analyses, and presentations. The research plan of the proposed career development application consists of two studies and the design of an intervention. Study 1 aims to collect qualitative data, using focus groups, regarding the expectations for the development of diabetes-related self-care behaviors and the process of transition to adult care as experienced by 4 groups: adolescents with type 1 diabetes, their parents, and pediatric and adult diabetes medical providers. Study 2 aims to collect quantitative data, in a 1-year observational study, regarding the natural trajectory of the development of diabetes-specific self-care behaviors in adolescents with type 1 diabetes. The project will investigate the differences in self-care behaviors across groups based on pubertal development and the associations of self-care behaviors with demographic, behavioral, and psychosocial variables. Data collected in Studies 1 and 2 along with the current literature will inform the design of an intervention to help adolescents with T1D acquire self-care skills necessary for greater independence and, ultimately, successful transfer to adult care. The intervention design will focus in increasing diabetes self-management skills, family problem-solving, and family communication around diabetes management tasks and decreasing diabetes- specific family conflict. This proposed project will result in a better understanding of the way adolescents with type 1 diabetes develop self-care skills, based on subjective and objective data, and the design of a novel approach to help pediatric patients develop self-care skills in preparation for the transfer from pediatric to adult diabetes care. Future research will empirically test the results of the currently proposed program of investigation regarding the process of transition. This 5-year career development plan aims to equip Dr. Markowitz with the experience and independence necessary for a career in pediatric diabetes behavioral research.

Public Health Relevance

This application supports the career development of a pediatric behavioral scientist committed to an independent career in clinical investigation. The project incorporates an experienced mentoring team, an institution and environment committed to the development of junior faculty, and a research plan that focuses on the important and timely topic of pediatric transition to adult care. The project will examine the way adolescents with type 1 diabetes develop the self-care skills necessary for successful, independent diabetes care prior to the transfer from pediatric to adult diabetes care providers.

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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Joslin Diabetes Center
United States
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Markowitz, Jessica T; Garvey, Katharine C; Laffel, Lori M B (2015) Developmental changes in the roles of patients and families in type 1 diabetes management. Curr Diabetes Rev 11:231-8
Rasbach, Lisa E; Volkening, Lisa K; Markowitz, Jessica T et al. (2015) Youth and parent measures of self-efficacy for continuous glucose monitoring: survey psychometric properties. Diabetes Technol Ther 17:327-34
Markowitz, Jessica T; Volkening, Lisa K; Butler, Deborah A et al. (2015) Youth-Perceived Burden of Type 1 Diabetes: Problem Areas in Diabetes Survey-Pediatric Version (PAID-Peds). J Diabetes Sci Technol 9:1080-5
Markowitz, Jessica T; Volkening, Lisa K; Laffel, Lori M B (2014) Care utilization in a pediatric diabetes clinic: cancellations, parental attendance, and mental health appointments. J Pediatr 164:1384-9
Markowitz, Jessica T; Cousineau, Tara; Franko, Debra L et al. (2014) Text messaging intervention for teens and young adults with diabetes. J Diabetes Sci Technol 8:1029-34
Markowitz, Jessica T; Alleyn, Cielo A; Phillips, Roxanne et al. (2013) Disordered eating behaviors in youth with type 1 diabetes: prospective pilot assessment following initiation of insulin pump therapy. Diabetes Technol Ther 15:428-33
Markowitz, Jessica T; Harrington, Kara R; Laffel, Lori M B (2013) Technology to optimize pediatric diabetes management and outcomes. Curr Diab Rep 13:877-85
Garvey, Katharine C; Markowitz, Jessica T; Laffel, Lori M B (2012) Transition to adult care for youth with type 1 diabetes. Curr Diab Rep 12:533-41
Markowitz, J T; Laffel, L M B (2012) Transitions in care: support group for young adults with Type 1 diabetes. Diabet Med 29:522-5