The Vanderbilt Center for Diabetes Translation Research (CDTR) has funds available (up to $30,000 per year for two years) to support pilot studies in translational research in the area of diabetes or obesity. The aim of the Vanderbilt Center for Diabetes Translation Research is to improve prevention and treatment of diabetes and/or obesity by promoting research that supports implementation, dissemination, and sustained use of effective interventions or approaches that improve the health of individuals with diabetes of obesity. The center seeks to support type II translation research. The NIDDK defines type II translational research (e.g. bedside to practice & the community) as testing innovative adaptations of evidence based approaches to prevent & treat diabetes &/or obesity that can be disseminated & sustained in clinical health care practice & other settings outside of the traditional academic research setting.
For the purpose of this FOA, type II translation is defined as research focused on translating interventions/approaches that have clearly demonstrated efficacy into real world health care settings, communities, & populations at risk. Type II translational research is distinct from type I translational research. Type I translational research (bench to bedside) builds on basic science findings & focuses on early phase research to “translate” these findings into potential interventions or therapeutics that might ultimately be tested in clinical trials. While type I translational research is a critically important piece of the research continuum, it is not the focus of this announcement. Type II translational research supported by the CDTR might include effectiveness, dissemination, implementation, & research. The target of this type of the research can be varied to include individuals, families, healthcare practitioners or systems, communities, &/or policy makers.
These funds are intended for:
- New investigators with an interest in a career in diabetes or obesity research,
- Investigators from other fields willing to bring their research expertise to diabetes- or obesity-relevant research,
- Investigators currently in the diabetes area whose proposed research constitutes a new direction, or for clinical & translational researchers who propose a joint research project.
The CDTR continues a collaborative relationship with the Vanderbilt Diabetes Research & Training Center in the
pursuit of translational research. This funding opportunity is, however, distinct from those of the Vanderbilt Diabetes
Research and Training Center.
The application should be submitted on the NIH form PHS 398, which can be obtained from the website: http://grants.nih.gov/grants/funding/phs398/phs398.html.
The pages we require are:
research description (FIVE PAGE LIMIT)
literature cited pages
Letter(s) of collaboration
Letter from departmental chair if Research Track Faculty
The application must be assembled into a single PDF document that contains all grant materials including letters of collaboration. Research track faculty MUST include a letter from his/her departmental chair describing how this award will serve in developing an independent research program & external research funding; this letter should also be included in the PDF.
Submit the following by the deadline: Friday, September 18th, 8:00 AM CDT
1. The PDF should be submitted electronically to firstname.lastname@example.org. Also include the names, institutions & email addresses of TWO potential INTERNAL & TWO potential EXTERNAL reviewers. These individuals cannot be collaborators or members of your department.
2. SIX hard copies (stapled) should be delivered to Jessica Kimber in room 807 Light Hall. Note that it is NOT necessary for the application to go through the Office of Sponsored Programs (formerly Office of Grants & Contracts Management) prior to submission.
QUESTIONS: Persons considering submitting a proposal & not certain of eligibility or persons with questions about Pilot & Feasibility grants should contact Dr. Tom Elasy (615-936-7772 or tom.elasy@Vanderbilt.edu). For questions about the grant submission process, please contact Jessica Kimber (615-875-6072 or email@example.com).
REVIEW CRITERIA: Proposed P&F studies should present a testable hypothesis & clearly delineate the question being asked, detail procedures to be followed, & discuss how the data will be analyzed & lead to future studies. Grants receive both internal & external review. Emphasis is placed on how the research might lead to new research ideas or research funding. For junior investigators, additional considerations include how this award will impact your career & the potential of the applicant to compete for independent research funding in the future. Research track faculty MUST include a letter from his/her departmental chair describing how this award will serve in developing an independent research program & external research funding.
The Center for Diabetes Translation Research is supported by NIH grant DK092986. Please acknowledge this in your publications.
Shelagh Mulvaney, PhD
Associate Professor of Nursing, Biomedical Informatics, and Pediatrics
"Feasibility of a Tailored Diabetes Self-Management Assessment and Support System"
The proposed pilot research will integrate patient-generated data focused on self-management and psychosocial barriers to self-management into routine adolescent diabetes care, modify clinical care based on that data, and implement a patient intervention within and outside the clinic that is tailored to individual self-management needs. The measure selected to document psychosocial barriers to self-management is the Barriers to Diabetes Adherence (BDA). The BDA is a validated measure that assesses 5 common and modifiable psychosocial barriers to self-management in adolescent type 1 diabetes. The assessment of psychosocial barriers is particularly relevant for adolescents and provides information useful for improving self-management and glycemic control. The BDA will provide unique information that bridges the gap between lived patient experiences and clinical care. We propose a system that utilizes ‘off the shelf’ technologies such as REDCap and text messaging to automate and administer the assessment and intervention. The system will be embedded in current workflow and the electronic health records system. One set of iterative design cycles will develop a digital report that integrates the BDA profile with objective self-management data and collaborative problem solving. A second set of design iterations will evaluate and improve implementation of the system and patient-centered communication within the clinic. Both sets of cycles integrate adolescent, parent, and clinician input. The research combines best practices from clinical and implementation science research to optimize quality, fidelity, and sustainability. Results will identify 1) a feasible clinic-based psychosocial assessment administration infrastructure, 2) barriers to and facilitators of implementing a patient-generated data system in diabetes care, and 3) methods to improve patient-centered communication in pediatric diabetes care. The proposed system builds on current clinical informatics processes, is innovative, and utilizes cost-effective automated processes that may be adopted by diabetes clinics with various levels of resources.
Lindsay Mayberry, PhD
Assistant Professor of Medicine
"Adapting a Mobile Phone Intervention to Improve Self- and Social-Regulation for Type 1 Diabetes During Emerging Adulthood"
Our scientific premise is that an intervention targeting self-regulation and social support will be beneficial for meeting the challenges of T1D management during the high-risk time of emerging adulthood. Individuals with better self-regulation (goal planning, regulating behaviors to facilitate goals) show less deterioration in A1c across early emerging adulthood.7 Even those with good regulation skills forget to engage in behaviors that meet daily diabetes goals.8 Emerging adults also benefit from social support elicited by disclosing diabetes needs to others,9 soliciting helpful support from family/friends, and managing the harmful involvement of others.10 However, needed support declines during this time as parental involvement declines,11 parents and friends are often viewed as unhelpful,12 and new relationships occur at work and school. Thus, emerging adults would benefit from skills to improve social support and those providing them with support (support persons, SPs) may benefit from information about how to provide that support. We propose to modify key features of the FAMS intervention (Family/friend Activation to Motivate Self-care), developed for adults with type 2 diabetes (T2D)13 for use with emerging adults with T1D. FAMS combines (1) text messaging to facilitate self-regulation and social support, (2) phone coaching to improve goal attainment and teach skills to manage social relationships, and (3) text messages to a SP to facilitate dialogue and support for diabetes. Among adults with T2D, FAMS was acceptable, delivered with high fidelity, and demonstrated improvements in family/friend involvement in self-management and in patients' diabetes self- management and self-efficacy.14 FAMS is well-suited to address the support emerging adults need for self- regulation and social support in a context of changing social relationships. However, several features of the intervention will need to be modified for the special case of emerging adults. For this pilot and feasibility project, we propose to leverage the existing infrastructure of FAMS, which is being evaluated with support from an NIDDK R01 (PI-Mayberry), to develop FAMS-T1D and assess its feasibility and acceptability in advance of a larger trial. The proposal is innovative and impactful as FAMS-T1D develops a theoretically-based intervention to reach a high-risk but understudied population in their daily life where self- management occurs, and teaches skills that can be leveraged across multiple social settings and relationships.
William Martinez, M.D., M.S.
Associate Professor of Medicine
“A Mobile Health Patient Portal Intervention to Engage Patients in Diabetes Care”
Dr. Martinez will design and test an innovative patient portal intervention (that includes functionality notifying patients when due for evidence-based diabetes monitoring and preventative services) as a means of engaging patients in diabetes care and improving the completion of evidence-based diabetes monitoring and preventative services.
Kerri Cavanaugh, M.D.
Kerri L. Cavanaugh, M.D.
Associate Professor of Medicine
“Determining Self-Management and Clinical Associations Related to Diabetes
Dr. Cavanaugh will characterize diabetes stigma and determine its impact on self-management and diabetes health outcomes. It is a novel factor that may be modified through patient-provider interventions to have potential widespread implications for the delivery of diabetes care. This pilot award is critical to launch this emerging research.
Lyndsay A. Nelson, Ph.D.
Research Assistant Professor of Medicine
“User Engagement with a Text Messaging Intervention for Diabetes Self-Care”
Dr. Nelson aims to address important gaps in knowledge to enhance the expanding use of text messaging technology to support chronic disease self-care. Understanding the determinants of intervention engagement can inform the design of interventions that optimize engagement and therefore potentiate impact.
Laurie Lovett Novak, Ph.D., MHSA
Assistant Professor of Biomedical Informatics
“The role of routines in diabetes self-care and adherence: A mixed-methods study”
Research has shown that adherence to recommended therapy and self-care practices improves clinical outcomes in diabetes, yet adherence remains a challenge for many people.
Dr. Novak’s work will focus on the development of practical interventions to assist patients in developing self-care routines that are successfully integrated into everyday life. She will also investigate the relationships between routines and adherence as based in everyday social practices, and the resilient elements of routines.
William John Heerman, M.D. MPH
Instructor in Pediatrics
Instructor in Medicine
Gestational weight gain is an established marker for both maternal and child health. Excess maternal weight gain during pregnancy is associated with insulin resistance and can produce infants who develop into children with a higher risk for insulin resistance, hypertension, and obesity in later life. Healthy lifestyle interventions targeted as early as preconception and throughout the prenatal period could therefore affect obesity prevention and lifelong health. While it is challenging to reach women preconception, it is critical that we do so given that pre-pregnancy BMI is the single best predictor of weight gain during pregnancy. This study will develop a prospective cohort of women who become pregnant during the study period of an ongoing, pragmatic randomized controlled trial that tests the efficacy of a community-based behavioral intervention to prevent pediatric obesity.
Lindsay S. Mayberry, Ph.D., MS
Research Instructor in Medicine
Despite accumulating evidence that family support is associated with better management of type 2 diabetes mellitus among adults, interventions targeting family support have been inconsistent in improving adult patients' outcomes. Interventions to date have predominately focused on delivering content to patients’ family members, which is often costly and challenging. Dr. Mayberry has spent the last 2 years conducting formative work with a low-income, racially diverse patient population to understand the role of diabetes-specific family behaviors in adult patients' adherence and glycemic control, and patients' preferences for family involvement in their diabetes management. She will leverage these findings to develop family-focused intervention content to be delivered to the individual patient and evaluate the efficacy of this approach in changing patient-reported family behaviors and patients' self-efficacy for adherence, adherence to self-care, and glycemic control.
Sarah Jaser, Ph.D.
Intervention for Mothers of Adolescents with Type 1 Diabetes
Mothers of adolescents with type 1 diabetes experience high levels of stress and depressive symptoms, which impair their ability to monitor and manage diabetes treatment effectively. Maternal stress and depressive symptoms are linked with negative outcomes in adolescents, including deteriorating glycemic control, poorer quality of life, and greater depressive symptoms. Dr. Jaser aims to develop and test the feasibility and preliminary efficacy of a cognitive-behavioral intervention to reduce depressive symptoms and improve parenting in mothers of adolescents with type 1 diabetes.
Rosette J. Chakkalakal, M.D.
Assistant Professor, Internal Medicine
Weight Changes During and After Pregnancy
in Women with Gestational Diabetes
Currently, women with gestational diabetes receive little advice on how to reduce their risk for type 2 diabetes after delivery. By studying modifiable risk factors in greater detail and designing interventions based on these results, Dr. Chakkalakal aims to develop effective, sustainable, and personalized strategies to help women with a recent history of gestational diabetes prevent or delay the onset of diabetes.
Gurjeet Birdee, M.D., MPH
Mind-body practices for patients with metabolic syndrome
There is a growing prevalence of metabolic syndrome in the U.S. which is related to poor health behaviors including physical inactivity and unhealthy diets. Mind-body practices are a novel intervention for patients with metabolic syndrome. The project will methodically translate and evaluate a common mind-body practice, yoga, for metabolic syndrome which may lead to new therapeutic options.
Shelagh Mulvaney, Ph.D.
Promoting Parental Problem Solving and Communication in Adolescent Diabetes
Adolescents with type 1 diabetes are at high risk for poor adherence and glycemic control. In order to address the needs of adolescents with type 1 diabetes, parents, and clinics, Dr. Mulvaney and her team have created an accessible and engaging internet adherence support intervention, named YourWay. The project will integrate two parallel websites, one for adolescents, and one for parents, to teach problem solving skills. Adolescents and parents will communicate via online problem solving cycles, which promote adolescent and parent communication and collaboration to solve adolescent problems.
Chandra Osborn, Ph.D., MPH
Design & Feasibility of a Patient Portal and Mobile Device-delivered Intervention
Although medications improve glycemic control, patient adherence to diabetes medications is often suboptimal. In other chronic disease contexts, health information technologies (HIT) have successfully delivered medication adherence-related information, motivation, and behavioral skills content that has resulted in improvements in medication adherence and clinical outcomes. This project will result in the design of a HIT delivered medication adherence intervention for patients with T2DM and test its feasibility.