对患有糖尿病的年轻成人的干预措施的评估：有弹性、有能力、积极的生活-远程医疗 (REAL-T) (REAL-T)

实验性的：生活方式干预

有弹性、有能力、有活力的生活-远程医疗 (REAL-T)

行为的：有弹性、有能力、有活力的生活-远程医疗 (REAL-T)

REAL-T 是一种个性化的职业治疗干预，专注于将糖尿病自我护理纳入参与者的日常习惯和惯例。 参加者接受大约 12 小时的干预，由经过糖尿病教育、动机性访谈和 REAL 糖尿病干预方案培训的持照职业治疗师通过远程医疗在 6 个月内提供。

无干预：日常护理

参与者将继续从他们选择的提供者那里获得常规糖尿病护理；他们不会接受任何与研究相关的干预。

使用糖化血红蛋白 (HbA1C) 将血糖控制从基线更改为 6 个月

HbA1C 是大约过去 12 周内平均血糖浓度的衡量标准。 HbA1C 将使用 DCA Vantage 分析仪护理点系统进行指尖采血测试或使用 DTI Laboratories 进行 AccuBase A1c 测试进行测量。 在基线和 6 个月后进行评估；从基线到报告 6 个月的变化。

使用“糖尿病相关生活质量审核 - 15”(ADD-QoL-15) 将糖尿病相关生活质量从基线更改为 6 个月后测试

评估糖尿病相关生活质量 (qol) 的 15 项问卷。 每个项目包含两个部分。 A 部分是：“如果我没有糖尿病，[问题主题]将会是”，后面跟着 5 个选项，范围从“非常好”（或类似；评分为 -3）到“更差”（或类似；评分为 -3）如1）。 第四个选项始终“相同”，得分为 0。B 部分是：“[问题主题]是”，后面跟着 4 个选项，范围从“非常重要”（得分为 3）到“一点也不重要”（得分为 0)。 对于每个问题，A 部分和 B 部分的分数相乘，然后将 15 个产品的分数相加得出总分。 问题 2、4、6、8、9 和 11 有初步的是/否问题，当给出“否”回答时，将跳过 A 和 B 部分，该问题的分数为 0。每个问题的最低分数问题为-9，最大为3，总分范围为-135至45。分数越高/越积极，代表结果越好；较低/较多的负分代表较差的结果。

使用“糖尿病困扰量表”(DDS)，将糖尿病相关情绪困扰从基线更改为 6 个月后测试

评估糖尿病相关情绪困扰的 17 项问卷。 总分（所有 17 个项目的平均分）范围为 1 到 6，分数越高表示结果越差。 子量表得分（情绪负担、医生相关困扰、治疗相关困扰和人际困扰）每个范围从 1 到 6，分数越高表明结果越差。 总分或子量表得分 2.0 - 2.9 应被视为“中度痛苦”，总分或子量表得分 > 3.0 应被视为“高度痛苦”。

使用范围时间百分比从基线到 6 个月后血糖测试的变化

通过佩戴连续血糖监测仪 14 天测量，血糖处于 70 至 180 mg/dl 之间的时间百分比。

血糖从基线到 6 个月测试后的变化（使用高血糖时间百分比）

通过佩戴连续血糖监测仪 14 天测量血糖高于 180 mg/dl 的时间百分比。

血糖从基线到 6 个月后测试的变化（使用低血糖时间百分比）

通过佩戴连续血糖监测仪 14 天测量血糖低于 70 mg/dl 的时间百分比。

Change From Baseline to 6-months in Functional Health and Well-being, Using the "SF-12v2® Health Survey"

Short Form 12-item Health Survey Ver. 2 (SF-12v2) is a 12-item questionnaire assessing functional health & well-being over the last 4 weeks in 8 health domains (physical functioning, role participation with physical health problems, bodily pain, general health, vitality, social functioning, role participation with emotional health problems, mental health), all from the patient's point of view. These 8 domains can be summarized into a physical component summary (PCS) and a mental component summary (MCS). Higher scores indicate a better health state. MCS and PCS scores range from 0-100. Scores are calibrated using general population-derived normative data so that 50 is the avg score or norm. Results can be further summarized into a single preference-based health utility number ranging from 1 (equivalent to perfect health) to 0 (equivalent to being dead), using a complex scoring algorithm (SF-6D) derived from surveying a general U.S. population's preferences for specific health states.

Change From Baseline to 6-months in Global Diabetes Self-management, Using the "Diabetes Self-Management Questionnaire-Revised" (DSMQ-R).

27-item questionnaire assessing self-care activities associated with glycemic control. Higher values indicate more effective self-management. Transformed scores = Actual sum of items / maximum possible sum of items x 10. Total transformed scores range from 0 to 10. Transformed scores on six sub-scales (Dietary control, Glucose management, Glucose monitoring, Medication adherence, Physical activity, and Physician contact) also range from 0 to 10.

Change From Baseline to 6-months in Medication Adherence, Using the "3-item Adherence Self-report Scale" Questionnaire

3-item questionnaire (Wilson,Lee, Fowler, & Rogers, 2016) assessing adherence to diabetes medication regimen. Item responses for the three adherence items are linearly transformed to a 0-100 scale with zero being the worst adherence, and 100 the best. A total summary score is calculated as the mean of the three individual items, with a range of 0 to 100.

Change From Baseline to 6-months in Self-efficacy for Performing Diabetes Self-management, Using the "Diabetes Empowerment Scale - Short Form" (DES-SF)

8-item questionnaire assessing self-efficacy for performing diabetes self-management, using 5-point likert scales. The scale is scored by averaging the scores of all completed items. Scores range from 8 to 40, with higher scores indicating higher self-efficacy.

Change From Baseline to 6-months in Autonomy of Taking Insulin and/or Checking Blood Sugar, Using the "Treatment Self-Regulation Questionnaire" (TSRQ)

19-item questionnaire, adapted for type 1 diabetes, assessing the degree to which a person's motivation for a particular behavior or a set of behaviors is relatively autonomous or self-determined. Each item can receive a value ranging from 1 - 7 as selected by the participant. The scale has 2 sub-scales: the autonomous regulatory style and the controlled regulatory style. Calculating the scores for the sub-scales consists of averaging the items on that sub-scale. A Relative Autonomous Motivation Index can be formed by subtracting the average for the controlled reasons from the average for the autonomous reasons. Scores range from 1 to 7, with 7 indicating a strong identification with the given autonomy style. The autonomous regulatory style represents the most self-determined form of motivation.

背景资料

该研究设计了包含 19 个项目的问卷，收集有关人口特征和基线医疗保健利用率（前 3 个月）的背景数据。 不计算总分。 个别项目的分数将用作各种分析中的协变量。