Expanding the Diabetes Homelessness Medication Support (D-Homes) program to Spanish speaking Hispanics

将糖尿病无家可归者药物支持 (D-Homes) 计划扩大到讲西班牙语的西班牙裔

• 批准号: 10510094
• 负责人: Katherine Diaz Vickery
• 金额: $ 9.72万
• 依托单位: HENNEPIN HEALTHCARE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-05 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10510094
• 关键词: Adult; Aftercare; Age; Award; Behavior Therapy; Behavioral; Behavioral trial; COVID-19; COVID-19 pandemic; Caring; Cessation of life; Chronic Disease; Clinical Trials; Communities; Data; Diabetes Mellitus; Diagnosis; Enrollment; Face; Feedback; Foundations; Fright; Funding; Future; Goals; Health Insurance; Health behavior; Health system; Healthcare; Hispanic; Hispanic Populations; Home; Homeless persons; Homelessness; Housing; Individual; Intervention; Interview; Language; Leadership; Link; Logistics; Low income; Mentored Patient-Oriented Research Career Development Award; Mexican; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Outcome Assessment; Participant; Persons; Pharmaceutical Preparations; Population; Prevalence; Procedures; Protocols documentation; Qualitative Research; Research; Resources; Risk; Risk Factors; Role; Services; Shelter facility; Structure; Time; Translating; Well in self; Work; acceptability and feasibility; arm; base; bilingualism; demographics; diabetes education; diabetes management; driving behavior; experience; glycemic control; health equity; high risk population; hispanic community; homeless shelters; improved; informant; innovation; medication compliance; pilot test; premature; programs; recruit; retention rate; safety net; satisfaction; skills; social

PROJECT SUMMARY/ABSTRACT Homeless people in the US face disproportionate risk for early death in part due to poorly controlled chronic diseases including diabetes. 1.5 million unique US adults access homeless shelters annually. People experiencing diabetes and homelessness develop complications 10 years earlier and die prematurely compared to their housed counterparts. This project works to achieve health equity for these people. Substantial evidence links medication adherence as a leading modifiable health behavior driving poor diabetes outcomes in low-income and homeless populations. Behavioral support for improved medication adherence among people experiencing diabetes and homelessness is the focus of our team’s ongoing work (K23DK118117). We’ve used qualitative data and community engaged approaches to develop a tailored behavioral intervention (the Diabetes Homeless Medication Support program [D-Homes]); pilot testing of this new intervention is ongoing. D-Homes offers 10 coaching sessions over 12 weeks targeting glycemic control via improved medication adherence. Coaching includes diabetes education and structured goal setting targeting medication adherence and psychological wellness. To date English fluency has been an enrollment criterion due to limited resources in the existing K23 award. Yet the Hispanic community has disproportionately higher rates of both homelessness and diabetes. This R-03 award will expand the D-Homes intervention to include Spanish speakers in two aims: (1) Adapt D-Homes protocols and translated treatment materials based on feedback from people with diabetes and homelessness who speak Spanish and are Hispanic (DH-SH). We will conduct 8-10 interviews to review materials, planned recruitment and retention strategies, and study logistics. (2) Assess feasibility and acceptability of the adapted D-Homes for DH-SH. We will recruit 12 DH-SH into a single-arm trial to assess acceptability and feasibility of (i) recruitment and retention; (ii) coaching content and treatment materials; (iii) outcome assessments. Data will include systematic tracking of recruitment and retention efforts, staff feedback, program satisfaction and post-treatment qualitative interviews. We hypothesize unique recruitment/retention needs and unique facilitators/barriers to medication adherence among DH-SH compared to English-speaking participants. Data will define solutions for use in future work. This study is significant because findings will enable a future, fully powered clinical trial of D-Homes that will enroll both English and Spanish speakers. Our team’s experience provides a robust foundation for this work: (1) Our bilingual/bicultural research staff supports our ongoing NIDDK-funded trial with Hispanic participants with type 2 diabetes (R01 DK113999); (2) The PI’s Mexican heritage, Spanish language skills, and leadership role at the local Health Care for the Homeless program; (3) Our team’s successful recruitment and retention of diverse participants in several behavioral trials with difficult-to-reach populations. This study is innovative as it will define necessary tailoring based on language and a key social risk factor to diabetes care, homelessness.

项目总结/文摘