I am pursuing a Mentored Patient-Oriented Research Career Development Award (K23) in order to gain a structured clinical research training experience that provides mentorship for my professional development as an independent behavioral diabetes researcher. Building on existing collaborations and preliminary studies, I have developed a program of research, and and have identified a senior and highly experienced Mentor, Clarissa Holmes, Ph.D., a research psychologist affiliated with Georgetown University Medical Center and Virginia Commonwealth University, who focuses on neurocognitive sequelae of pediatric diabetes. Mark Stein, Ph.D., Chair of Children National Medical Center's (CNMC) Department of Psychology, will serve as my co-Mentor, providing expertise in child behavior research. This K-23 proposal is designed to (1) provide rigorous and multidisciplinary training in biologic, medical, and behavioral aspects of Type 1 diabetes, as well as research methodology, and (2) test the efficacy of a behavioral intervention program to improve biological (A1C, hypoglycemia, glycemic excursion), behavioral (diabetes self-care), and medical (lipid profile, physical growth) outcomes in children with Type 1 diabetes. Specifically, I will conduct a randomized controlled trial with 132 children 10-11 years old who have at least a 6 month history of Type I diabetes, to compare standard diabetes education (SDE) to SDE plus psychosocially enhanced adherence promotion (SDE+AP). The SDE+AP program focuses on self-monitoring of blood glucose, insulin injections, and nutrition and exercise in children and their parents, and is designed to sustain a high level of parental involvement in these activities as children mature. In addition to mentoring by Drs. Holmes and Stein, this project will be supported by the extensive resources of CNMC and its Pediatric Clinical Research Center. The proposed training and research will assure my professional development as an independent clinical researcher, and lead to future R01 funding to improve outcomes for children with diabetes.