Sleep, self‐management, neurocognitive function, and glycemia in emerging adults with Type 1 diabetes mellitus: A research protocol

Griggs, Stephanie; Redeker, Nancy S.; Crawford, Sybil L.

doi:10.1002/nur.22051

Cited by 11 publications

(4 citation statements)

References 78 publications

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“…Young adulthood (ie, 18 to 34 years old) is a time of critical health and psychosocial concerns in T1D (eg, pregnancy, transition from pediatric to adult care, and parental to personal health insurance), but consensus statements recognize that this age group is understudied in clinical trials [ 2 ]. Successful strategies for reaching this group include targeting by the age listed on social media profile [ 10 ] or medical record [ 10 , 21 ], or online support groups specific to young adults [ 9 ]. We, unfortunately, did not design our web-based methods to achieve such targeting; our news feed advertisements were targeted based on diabetes-related profile interests, which were uncommon among young adults, and the individuals who volunteered to start our snowball sampling happened to be middle-aged rather than young adults.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study

Ash¹,

Griggs²,

Nally³

et al. 2021

JMIR Diabetes

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Background Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic. Objective Our objectives for this study were to (1) evaluate the effectiveness and cost of using social media news feed advertisements, a clinic-based approach method, and web-based snowball sampling to reach inadequately active adults with T1D and (2) compare characteristics of enrollees against normative data. Methods Participants were recruited between November 2019 and August 2020. In method #1, Facebook and Instagram news feed advertisements ran for five 1-to-8-day windows targeting adults (18 to 64 years old) in the greater New Haven and Hartford, Connecticut, areas with one or more diabetes-related profile interest. If interested, participants completed a webform so that the research team could contact them for eligibility screening. In method #2, patients 18 to 24 years old with T1D were approached in person at clinical visits in November and December 2019. Those who were interested immediately completed eligibility screening. Older patients could not be approached due to clinic restrictions. In method #3, snowball sampling was conducted by physically active individuals with T1D contacting their peers on Facebook and via email for 48 days, with details to contact the research staff to express interest and complete eligibility screening. Other methods referred participants to the study similarly to snowball sampling. Results In method #1, advertisements were displayed to 11,738 unique viewers and attracted 274 clickers (2.33%); 20 participants from this group (7.3%) volunteered, of whom 8 (40%) were eligible. Costs averaged US $1.20 per click and US $95.88 per eligible volunteer. Men had lower click rates than women (1.71% vs 3.17%; P<.001), but their responsiveness and eligibility rates did not differ. In method #2, we approached 40 patients; 32 of these patients (80%) inquired about the study, of whom 20 (63%) volunteered, and 2 of these volunteers (10%) were eligible. Costs including personnel for in-person approaches averaged US $21.01 per inquirer and US $479.79 per eligible volunteer. In method #3, snowball sampling generated 13 inquirers; 12 of these inquirers (92%) volunteered, of whom 8 (67%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $20.59 per eligible volunteer. Other methods yielded 7 inquirers; 5 of these inquirers (71%) volunteered, of whom 2 (40%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $34.94 per eligible volunteer. Demographic overrepresentations emerged in the overall cohort (ie, optimal glycemic control, obesity, and low exercise), among those recruited by news feed advertisements (ie, obesity and older age), and among those recruited by snowball sampling (ie, optimal glycemic control and low exercise). Conclusions Web-based advertising and recruitment strategies are a promising means to attract adults with T1D to clinical trials and exercise interventions, with costs comparing favorably to prior trials despite targeting an uncommon condition (ie, T1D) and commitment to an intervention. These strategies should be tailored in future studies to increase access to higher-risk participants. Trial Registration ClinicalTrials.gov NCT04204733; https://clinicaltrials.gov/ct2/show/NCT04204733

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Section: Discussionmentioning

confidence: 99%

“…Over the course of the 9-month recruitment window, 3 participants in a prior Yale study for T1D [ 21 ] expressed interest in volunteering for further studies, and 4 viewers of the study on ClinicalTrials.gov emailed us requesting more information. These 7 people were considered to be inquirers , analogous to clickers in method #1.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study

Ash¹,

Griggs²,

Nally³

et al. 2021

JMIR Diabetes

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“…Young adults completed sleep diaries daily in the mornings and evenings to track daytime sleep-related behaviors (eg, caffeine use, exercise) and nocturnal sleep-wake characteristics (eg, bedtime, awakening). Actigraphy scoring methods were reported previously (33).…”

Section: Methodsmentioning

confidence: 99%

Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes

Griggs

Grey

Crawford

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Short sleep duration and sleep disruptions are associated with impaired glucoregulation in type 1 diabetes (T1D). However, the mechanistic pathways between sleep and glucose variability remain unclear. Objective To determine within-and between-person associations between objective sleep-wake characteristics and glucose variability indices. Design/Setting Multilevel models (MLMs) were used to analyze concurrent sleep and glucose patterns over seven days in 42 young adults with T1D in their natural home environment. Patients or Other Participants Young adults with T1D (mean age of 22.2 ± 3.0 years, HbA1C 7.2%, 32.6% male) for at least 6 months with no other medical or major psychiatric comorbidity were included. Main Outcome Measure(s) Sleep-wake characteristics via wrist actigraphy and glucose variability indices via a continuous glucose monitor (CGM). Results Lower sleep efficiency predicted higher glucose variability (less time in range β= .011 and more time in hyperglycemia β= -.011) within-person. A longer wake after sleep onset and more sleep disruptions were associated with higher glucose variability between persons (β= .28 - .31). Higher glucose variability predicted poorer sleep within-person (delayed bedtime, waketime, mid-sleep time, and lower sleep efficiency), while higher glucose variability was associated with poorer sleep and more sleep disruptions between persons (lower sleep efficiency, longer wake after sleep onset, and a higher sleep fragmentation index). Conclusions Clinicians can address the reciprocal nature of the sleep-glucose relationship by optimizing sleep and targeting efforts towards a euglycemic range overnight. Sleep habits are a modifiable personal target in diabetes care.

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“…A qualitative methodology allows for an in-depth understanding of the reasons for adopting certain behaviors. Several authors [12,17,18] claimed that using an exclusively quantitative methodology in the study of lifestyle leads to a lack of knowledge about the motivations behind the behaviors adopted. Therefore, the objective of this systematic review is to comprehensively examine the various lifestyle aspects of emerging adults with T1DM, recognizing that this condition may necessitate unique considerations in different life spheres during a challenging, transitional phase marked by significant changes and demands.…”

Section: Introductionmentioning

confidence: 99%

Lifestyle in Emerging Adults with Type 1 Diabetes Mellitus: A Qualitative Systematic Review

Núñez-Baila,

Gómez-Aragón,

Marques-Silva

et al. 2024

Healthcare

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Emerging adulthood is a transitional stage with significant lifestyle changes, making it especially challenging for those living with type 1 diabetes mellitus. This systematic review synthesizes qualitative research to explore how emerging adulthood (18–29 years) influences lifestyle behaviors in individuals with type 1 diabetes mellitus. CINAHL, Cochrane Library, Global Health, Nursing & Allied Health Premium, PsycINFO, PubMed, Scopus, and WOS were searched for original qualitative studies addressing the lifestyle of 18–31-year-olds with type 1 diabetes mellitus, published between January 2010 and March 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-five studies met the inclusion criteria and their findings were categorized into eight topics (emotions and feelings, nutrition, perceptions, risky behaviors, self-care, sleep, social relationships, and stigma) using meta-aggregation, as outlined in the Joanna Briggs Institute Manual for Evidence Synthesis. The spontaneity characteristic of emerging adulthood can undermine self-care. This is because new environments, schedules, and relationships encountered during this life stage often lead to the neglect of diabetes management, owing to the various social, academic, and occupational demands. This review highlights the necessity of creating health promotion strategies tailored to the unique lifestyle aspects of emerging adults with type 1 diabetes mellitus.

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Sleep, self‐management, neurocognitive function, and glycemia in emerging adults with Type 1 diabetes mellitus: A research protocol

Cited by 11 publications

References 78 publications

Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study

Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study

Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes

Lifestyle in Emerging Adults with Type 1 Diabetes Mellitus: A Qualitative Systematic Review

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