Latinos Understanding the Need for Adherence in Diabetes using Care Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E)
拉丁美洲人利用护理协调、综合医疗和行为护理以及电子健康 (LUNA-E) 了解糖尿病患者坚持治疗的必要性
基本信息
- 批准号:10424515
- 负责人:
- 金额:$ 60.88万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-06-08 至 2026-02-28
- 项目状态:未结题
- 来源:
- 关键词:AddressAdherenceAdultAffectBehaviorBehavioralBlood PressureCaringChronic CareClinicClinicalCollaborationsCommunicationCommunitiesCommunity HealthcareComplications of Diabetes MellitusDiabetes MellitusDistressEarly InterventionEducationEducational CurriculumEffectivenessEffectiveness of InterventionsElectronic Health RecordEnvironmentFederally Qualified Health CenterGlycosylated hemoglobin AHealthHealth PersonnelHealth PromotionHealth educationHealthcareHispanic Community Health Study/Study of LatinosHispanic PopulationsHomeImmigrantInsulinInterventionKnowledgeLatinoLatino PopulationLipidsMeasuresMediatingMediator of activation proteinMedicalMedical Care TeamMedical centerMental DepressionMethodsMexicanMexicoModelingNeighborhood Health CenterNon-Insulin-Dependent Diabetes MellitusOutcomeParticipantPatientsPopulationPrevalencePrimary Health CareProcessPublic HealthQuasi-experimentRandomizedRandomized Controlled TrialsReach Effectiveness Adoption Implementation and MaintenanceResearchResourcesRestRiskRisk FactorsRoleSelf CareSelf ManagementService delivery modelStructureTarget PopulationsTestingTrainingTrustUniversitiesVisitanxiety symptomsarmbasebehavior changebehavioral adherencebehavioral healthcare coordinationcare deliverycare outcomescare providerschronic care modelclinical decision supportcohortcommunity partnershipcomorbiditydashboarddepressive symptomsdiabetes controldiabetes distressdiabetes self-managementeHealtheffectiveness testingevidence baseexperienceglycemic controlhealth care deliveryhealth care modelhealth care servicehealth communicationhealth disparityhealth traininghigh riskimprovedinnovationmedication compliancememberminority communitiespatient health informationpatient orientedpatient portalprimary outcomeprocess evaluationprogramspsychological distresspsychosocialracial and ethnicrecruitresource guidessocioeconomic disadvantagestandard of caretechnology validationtreatment armtreatment as usualtrend
项目摘要
Project Summary/Abstract
The proposed Latinos Understanding the Need for Adherence in Diabetes using Care
Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E) randomized
controlled trial will test the effectiveness of an innovative patient-centered, team-based, primary
care intervention in improving diabetes outcomes in Latino patients of San Ysidro Health (SYH),
a large federally qualified health center (FQHC). The proposal builds on more than 17 years of
research by our academic (San Diego State University; SDSU) community (SYH) partnership.
LUNA-E will recruit and randomize N=400 Latino adults with poorly controlled diabetes into "usual
care plus" (UCP) or "special intervention" (SI). UCP represents methods recently initiated by the
SYH Patient Centered Medical Home initiative, in which a medical assistant provides care
coordination, referrals, and brief health education in collaboration with the primary care provider.
The LUNA-E SI is a highly integrated, culturally specific for diabetes, team-based approach
informed by the Chronic Care Model of healthcare and Resources and Supports for Self-
Management Model of behavior change. The SI includes: 1) Care Coordination by a specially
trained health navigator; 2) Visits with a Behavioral Health Provider with knowledge of diabetes,
local culture, the integrated model, and psychosocial aspects of diabetes care; 3) Care integration
among the Primary Care Provider, Behavioral Health Provider and Care Coordinator via a clinical
decision support “dashboard” in the patient electronic health record (EHR); 4) Evidence-based,
culturally adapted diabetes self-management education delivered via patient portal. The study will
test hypotheses that the LUNA-E SI will lead to larger improvements in glycemic control (HbA1c
levels; Aim 1) and psychological distress (depression and anxiety symptoms; Aim 2) at 6-months
post randomization when compared to UCP, and the degree to which these differences are
explained by conceptually driven mediators (improved resources and supports for self-
management, patient activation, medication adherence and self-management behaviors; Aim 3)
A matched retrospective True Usual Care (TUC) group (N=200) will be extracted from EHR using
propensity score matching, to evaluate diabetes outcomes in UCP and SI versus patients with
little to no care coordination and health education and no study visits. A thorough process
evaluation will assess intervention reach, effectiveness, adoption, implementation, and
maintenance (RE-AIM). LUNA-E has excellent potential for high impact and broad dissemination
due to its community partnered approach, reliance on EHR and E-Health, and implementation
within a large, exemplar FQHC primary care environment.
项目总结/摘要
拟议的拉丁美洲人了解糖尿病使用护理坚持的必要性
协调、综合医疗和行为护理以及电子健康(LUNA-E)
对照试验将测试创新的以患者为中心,以团队为基础,主要
护理干预改善圣伊西德罗健康(SYH)拉丁美洲患者的糖尿病结局,
一个大型的联邦合格的健康中心(CFDHC)。该提案建立在17年多来
由我们的学术(圣地亚哥州立大学; SDSU)社区(SYH)合作伙伴进行研究。
LUNA-E将招募N=400名糖尿病控制不佳的拉丁裔成年人,并将其随机分为“普通”组和“普通”组。
附加护理(UCP)或特殊干预(SI)。UCP代表了最近发起的方法,
SYH以患者为中心的医疗之家倡议,其中医疗助理提供护理
与初级保健提供者合作进行协调、转诊和简短的健康教育。
LUNA-E SI是一种高度整合的、针对糖尿病文化的、基于团队的方法
了解慢性病护理模式的医疗保健和资源,并支持自我,
行为改变的管理模式。SI包括:1)由专门的
受过训练的健康导航员; 2)与具有糖尿病知识的行为健康提供者一起访问,
糖尿病护理的当地文化、综合模式和心理社会方面; 3)护理整合
在初级保健提供者、行为健康提供者和护理协调员之间,
患者电子健康记录(EHR)中的决策支持“仪表板”; 4)基于证据,
通过患者门户网站提供适应文化的糖尿病自我管理教育。这项研究将
检验LUNA-E SI将导致血糖控制(HbA 1c)更大改善的假设
水平;目标1)和心理困扰(抑郁和焦虑症状;目标2)在6个月
与UCP相比,随机化后,以及这些差异的程度
由概念驱动的调解人解释(改善资源和支持自我,
管理、患者激活、药物依从性和自我管理行为;目标3)
匹配的回顾性真实医疗护理(TUC)组(N=200)将使用
倾向评分匹配,以评价UCP和SI患者与
几乎没有护理协调和健康教育,也没有研究访问。一个彻底的进程
评价将评估干预措施的范围、有效性、采用情况、实施情况,
维护(RE-AIM)。LUNA-E具有巨大影响和广泛传播的巨大潜力
由于其社区合作的方法,对EHR和E-Health的依赖,
在一个大型的,示范性的CMEHC初级保健环境中。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Linda C Gallo其他文献
Interpersonal control and cardiovascular reactivity: goals, behavioral expression, and the moderating effects of sex.
人际控制和心血管反应:目标、行为表达和性的调节作用。
- DOI:
- 发表时间:
1996 - 期刊:
- 影响因子:7.6
- 作者:
T. W. Smith;J. P. Limón;Linda C Gallo;L. Ngu - 通讯作者:
L. Ngu
Abstract P551: Public Sentiment Toward Immigrants and Cardiovascular Disease Risk Among Hispanics/Latinos in the Hispanic Community Health Study/Study of Latinos
摘要 P551:西班牙裔社区健康研究/拉丁裔研究中西班牙裔/拉丁裔对移民和心血管疾病风险的公众情绪
- DOI:
10.1161/circ.141.suppl_1.p551 - 发表时间:
2020 - 期刊:
- 影响因子:37.8
- 作者:
Danielle M. Crookes;L. Bates;A. Boehme;E. Chambers;M. Daviglus;R. Demmer;Linda C Gallo;A. Giachello;F. Gonzalez;K. Perreira;C. Isasi;M. Perera;Liana K. Preudhomme;S. Suglia - 通讯作者:
S. Suglia
Psychosocial influences on coronary heart disease
心理社会对冠心病的影响
- DOI:
- 发表时间:
1994 - 期刊:
- 影响因子:0
- 作者:
Timothy W. Smith;Linda C Gallo - 通讯作者:
Linda C Gallo
Community-Created Programs: Can They Be the Basis of Innovative Transformations in Our Health Care Practice? Implications from 15 Years of Testing, Translating, and Implementing Community-Based, Culturally Tailored Diabetes Management Programs
社区创建的项目:它们能否成为我们医疗保健实践创新转型的基础?
- DOI:
- 发表时间:
2012 - 期刊:
- 影响因子:0
- 作者:
A. Philis;T. Gilmer;James Schultz;Chris Walker;A. Fortmann;Linda C Gallo - 通讯作者:
Linda C Gallo
Use of conventional care and complementary/alternative medicine among US adults with arthritis.
美国成人关节炎患者使用传统护理和补充/替代药物。
- DOI:
- 发表时间:
2012 - 期刊:
- 影响因子:5.1
- 作者:
Katherine D. Hoerster;Dalila A Butler;J. Mayer;T. Finlayson;Linda C Gallo - 通讯作者:
Linda C Gallo
Linda C Gallo的其他文献
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{{ truncateString('Linda C Gallo', 18)}}的其他基金
Latinos Understanding the Need for Adherence in Diabetes using Care Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E)
拉丁美洲人利用护理协调、综合医疗和行为护理以及电子健康 (LUNA-E) 了解糖尿病患者坚持治疗的必要性
- 批准号:
10569120 - 财政年份:2021
- 资助金额:
$ 60.88万 - 项目类别:
Dulce Digital-Me: An Adaptive mHealth Intervention for Underserved Hispanics with Diabetes
Dulce Digital-Me:针对服务不足的西班牙裔糖尿病患者的适应性 mHealth 干预措施
- 批准号:
9237892 - 财政年份:2016
- 资助金额:
$ 60.88万 - 项目类别:
Dulce Digital-Me: An Adaptive mHealth Intervention for Underserved Hispanics with Diabetes
Dulce Digital-Me:针对服务不足的西班牙裔糖尿病患者的适应性 mHealth 干预措施
- 批准号:
10006888 - 财政年份:2016
- 资助金额:
$ 60.88万 - 项目类别:
Medical Assistant Health Coaching for Diabetes in Diverse Primary Care Settings
不同初级保健机构中糖尿病医疗助理健康指导
- 批准号:
9769704 - 财政年份:2015
- 资助金额:
$ 60.88万 - 项目类别:
Mi Puente: My Bridge to Better Cardiometabolic Health and Well-being
Mi Puente:我改善心脏代谢健康和福祉的桥梁
- 批准号:
9150313 - 财政年份:2015
- 资助金额:
$ 60.88万 - 项目类别:
Mi Puente: My Bridge to Better Cardiometabolic Health and Well-being
Mi Puente:我改善心脏代谢健康和福祉的桥梁
- 批准号:
9318346 - 财政年份:2015
- 资助金额:
$ 60.88万 - 项目类别:
Medical Assistant Health Coaching for Diabetes in Diverse Primary Care Settings
不同初级保健机构中糖尿病医疗助理健康指导
- 批准号:
9670936 - 财政年份:2015
- 资助金额:
$ 60.88万 - 项目类别:
Ancillary to HCHS/SOL: Sociocultural Factors and CVD risk/prevalence in Hispanics
HCHS/SOL 的辅助:西班牙裔的社会文化因素和 CVD 风险/患病率
- 批准号:
7941921 - 财政年份:2009
- 资助金额:
$ 60.88万 - 项目类别:
Ancillary to HCHS/SOL: Sociocultural Factors and CVD risk/prevalence in Hispanics
HCHS/SOL 的辅助:西班牙裔的社会文化因素和 CVD 风险/患病率
- 批准号:
7855365 - 财政年份:2009
- 资助金额:
$ 60.88万 - 项目类别:
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