Better Together: Leveraging primary care and social network resources to create a patient-centered approach to improve diabetes among immigrant communities

更好地在一起：利用初级保健和社交网络资源创建以患者为中心的方法来改善移民社区的糖尿病

• 批准号: 10198690
• 负责人: Megha Shah
• 金额: $ 15.24万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-19 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10198690
• 关键词: Address; Adopted; Affect; Africa; African; Asia; Award; Behavior; Belief; Biometry; Blood Pressure; Body Weight; Calories; Child; Clinic; Clinic Visits; Clinical Sciences; Communities; Data; Development Plans; Diabetes Mellitus; Diet; Diffusion; Education; Educational Curriculum; European; Evaluation; Family; Family Practice; Family member; Focus Groups; Friends; Funding; Gender; Generations; Glycosylated Hemoglobin; Goals; Grant; Habits; Health; Health Services Accessibility; Health behavior; Health education; Health system; High Prevalence; Home; Immigrant; Individual; Intervention; K-Series Research Career Programs; Latino; Life Cycle Stages; Life Style; Lipids; Manuscripts; Measurement; Minority; Modeling; Morbidity - disease rate; Motivation; Muslim population group; Native Americans; Native-Born; Natural experiment; Network-based; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Pathway Analysis; Patient Recruitments; Patients; Perception; Persons; Physical activity; Pilot Projects; Plasma; Population; Prediabetes syndrome; Primary Health Care; Protocols documentation; Research; Resources; Role; Rural; Scientist; Site; Social Network; South African; South Asian; Spouses; Testing; Training; Translational Research; Underrepresented Populations; Vulnerable Populations; Weight; Weight maintenance regimen; Woman; Work; Writing; acceptability and feasibility; base; behavior change; behavioral outcome; career; career development; clinical care; clinical practice; cost; data hub; design; diabetes risk; diabetes self-management; disparity reduction; epidemiologic data; ethnic minority population; evidence base; experience; glycemic control; group intervention; health care disparity; healthy lifestyle; high risk; hypertension control; implementation science; improved; innovation; intervention program; lifestyle factors; lifestyle intervention; male; medical appointment; member; men; mortality; patient oriented; patient population; peer; personalized care; preference; prevent; primary care setting; primary outcome; programs; recruit; satisfaction; secondary outcome; skills; social; social cohesion; translational study; uptake

PROJECT SUMMARY The long-term objective of this project is to improve the reach and uptake of evidence-based lifestyle programs to reduce disparities in diabetes (T2D) related outcomes among immigrant men. The study will explore the role of social networks, defined as family and peers, to support healthy lifestyle behaviors among immigrant men through the shared medical appointment model and to understand the diffusion of health behaviors amongst participants’ social networks. The aims are to: (1a & 1b) Qualitatively explore perceptions and cultural preferences for a clinic-based shared medical appointment intensive lifestyle intervention to inform program adaptation; (2) Conduct a pilot study to evaluate the feasibility and acceptability of social network- based (participant + social partner) versus individual-based (participant only) SMA ILI among South Asian and West African immigrant participants with prediabetes/T2D; and (3) Assess the behavioral outcomes of the pilot intervention amongst members of participants’ social networks to determine if there are spillover effects. The project will prepare Dr. Shah to transition to an independent clinician scientist using innovative health system- based models to leverage family and social networks to improve health outcomes and reduce disparities among vulnerable populations. Her career development plan includes these training goals to: (1) Gain skills in cultural adaptation of an intervention to reduce prediabetes/T2D; (2) Develop expertise in pragmatic evaluation design, protocols, and analysis; (3) Obtain advanced skills in social network analysis; and (4) Advance skills in presentation, manuscript and grant-writing. The research will be conducted in the primary care setting of the Emory Family Medicine Center in Dunwoody, GA, which serves a diverse patient population and is the site of Dr. Shah’s clinical practice. This K23 Career Development Award will also leverage the training resources of the Georgia Clinical and Translational Science Alliance. Results from this project will provide pilot data for an R01/R18 application to further evaluate the reach and uptake of culturally adapted lifestyle interventions for immigrant men with prediabetes and type 2 diabetes, an underrepresented group in current translational studies to date.

项目摘要 该项目的长期目标是改善基于证据的生活方式计划的覆盖范围和吸收 减少糖尿病（T2D）与移民男性相关的结果的差异。该研究将探索 社交网络的作用，被定义为家庭和同龄人，以支持移民的健康生活方式行为 通过共享的医疗任命模型的男人，并了解健康行为的扩散 在参与者的社交网络中。目的是：（1a＆1b）定性探索感知和 基于诊所的共享医疗任命强化生活方式干预的文化偏好，以告知 程序适应； （2）进行试点研究以评估社交网络的可行性和可接受性 - 基于（参与者 +社会合作伙伴）与基于个人的（仅参与者）SMA ILI和SMA ILI和SMA ILI和 西非移民参与者患有糖尿病前/T2D； （3）评估飞行员的行为结果 参与者社交网络成员之间的干预，以确定是否存在Spilover效应。这 项目将准备Shah博士使用创新的卫生系统过渡到独立临床科学家 - 基于基于家庭和社交网络来改善健康成果并减少分配的模型 在弱势群体中。她的职业发展计划包括以下培训目标：（1）获得技能 干预措施的文化适应以减少糖尿病前期/T2D； （2）发展务实评估方面的专业知识 设计，协议和分析； （3）获得社交网络分析的高级技能； （4）提高技能 演讲，手稿和赠款写作。该研究将在初级保健环境中进行 乔治亚州邓伍德（Dunwoody）的埃默里家庭医学中心（Emory Family Center）为患者人群提供不同 Shah博士的临床实践。该K23职业发展奖还将利用 佐治亚州的临床和转化科学联盟。该项目的结果将为A提供试验数据 R01/R18应用程序进一步评估文化适应的生活方式干预措施的影响和吸收 糖尿病前和2型糖尿病的移民男性，当前翻译中的代表性不足 迄今为止的研究。