# ONBOARD: OvercomiNg Barriers & Obstacles to Adopting Diabetes Devices

> **NIH NIH K23** · STANFORD UNIVERSITY · 2020 · $169,601

## Abstract

Project Summary
Type 1 diabetes (T1D) is a burdensome chronic disease that requires a demanding self-management regimen
to optimize glycemic control and prevent short- and long-term complications. Advances in insulin pumps and
continuous glucose monitoring (CGM) technologies have enabled improved glycemic control and reduced risk
of complications and have laid the groundwork for the arrival of closed loop systems – the first of which
became commercially available in 2017. Closed loop systems, which integrate an insulin pump and CGM to
partially automate insulin delivery, represent a major paradigm shift in diabetes care such that people with T1D
will offload some of the diabetes management burden to an automated system, resulting in tighter glucose
control and better quality of life. However, a minority of adults (18-50) with T1D currently use CGM – a core
component of closed loop - and a concerning proportion quit CGM within the first year, which does not bode
well for the adoption of closed loop. Low uptake and high discontinuation of CGM among adults with T1D
signal the need for well-designed, tailored interventions that provide education, support and problem-solving
skills to empower device users to work through physical, social, and other barriers to maximize benefit from
advanced diabetes technologies. In this application, Molly Tanenbaum, PhD, proposes a series of studies with
an overarching goal of developing advanced behavioral research skills while refining a comprehensive
behavioral intervention package to equip adults with T1D with the resources and skills to maximize benefit and
minimize daily interference from CGM, with application for closed loop system adoption. The specific aims in
this career development award proposal are: 1) to deliver, iteratively refine a behavioral intervention package,
ONBOARD (OvercomiNg Barriers & Obstacles to Adopting Diabetes Devices), in a small sample of adults with
T1D using CGM, and then conduct a randomized controlled trial of ONBOARD comparing device use, health
and psychosocial outcomes after adults with T1D receive the intervention versus CGM-only; and 2) to use
qualitative interview data to adapt ONBOARD for adults initiating closed loop systems. Results from these
studies will provide preliminary data to inform a larger trial of ONBOARD for CGM and closed loop adoption
and sustained use in a future R01 application. Dr. Tanenbaum’s long-term career objective is to be an
independent investigator with a programmatic line of research focused on optimizing use of emergent diabetes
technology to improve health and quality of life outcomes for adults with T1D. The mentoring, coursework, and
career development activities proposed in this 5-year training award will provide Dr. Tanenbaum with the
advanced statistical training and experience conducting a randomized controlled trial – skills necessary for a
successful career as an independent behavioral diabetes researcher.

## Key facts

- **NIH application ID:** 9838746
- **Project number:** 5K23DK119470-02
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Molly Leah Tanenbaum
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $169,601
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9838746

## Citation

> US National Institutes of Health, RePORTER application 9838746, ONBOARD: OvercomiNg Barriers & Obstacles to Adopting Diabetes Devices (5K23DK119470-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9838746. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*