Objective: Women with diabetes have increased risks of pregnancy-related complications. Knowledge of preventing these risks can be helpful. This paper describes the understanding and knowledge of diabetes and reproductive health of adolescent females with type 1 diabetes (T1D). Research Design and Methods:For this secondary analysis, a descriptive mixed-method design was employed using baseline data from adolescents enrolled in a preconception counseling (PC) intervention study (READY-Girls program) targeting adolescent women with diabetes to enhance reproductive health awareness, knowledge, beliefs, decision-making skills, and behaviors. Participants (aged 13-20 yrs) were recruited from 2 university-based diabetes clinics. Content analysis was used to identify recurring themes on 3 open-ended computer-based questions regarding the understanding of diabetes and pregnancy, contraception, and PC; kappa coefficients were used to assess inter-coder agreement. Subscale scores from multiple-choice vignettes were computed in terms of 100% correctness (<70% indicated low levels) for knowledge of diabetes and pregnancy, contraception, and PC. Qualitative and quantitative results were compared.Results: Participants (n=101) were on average 15.8 yrs, 21% were sexually active with a mean age at sexual debut of 15.3yrs. Overarching themes from qualitative data were that participants knew "little or nothing" and had misconceptions regarding diabetes and pregnancy, contraception, and PC. Inter-coder agreement for content analysis was high. Knowledge scores were low (diabetes and pregnancy, 64.5%; diabetes and contraception, 79.8%; PC, 67.5%).Conclusion: Risky behavior and low knowledge scores confirmed their perceived lack of understanding from the open-ended questions regarding diabetes and pregnancy and PC. Teens had greater knowledge of contraception. Diabetes education should include PC and reproductive health for teens with diabetes.

The Clinical Trials Transformation Initiative (CTTI) Strengthening the Investigator Community Project was prompted by the need to understand the reasons for high rates of turnover among investigators who lead US Food and Administration-regulated clinical trials at research sites. Because investigator knowledge and experience directly affect the quality and ultimate success of clinical trials, investigator turnover has important implications for the research enterprise, as well as the patients and other stakeholders who depend on the outcomes of clinical research. The CTTI project team used findings from both quantitative and qualitative research activities, as well as input from an expert meeting with multiple stakeholders, to delineate key concerns faced by investigators and recommend practical, action-based solutions. The recommendations focus on strengthening four key categories of site-based research activity: developing site-based research infrastructure and staff, optimizing trial execution and conduct, improving site budget development and contract negotiations, and discovering opportunities for conducting additional trials.