REACH-Es: Adapting a digital health tool to improve diabetes medication adherence among Latino adults

REACH-E：采用数字健康工具来提高拉丁裔成年人糖尿病药物的依从性

基本信息

批准号：
10641103
负责人：
Jacqueline Anne Seiglie
金额：
$ 19.65万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10641103
关键词：
Address Adherence Adult Behavior Therapy Biometry Clinical Clinical Trials Communication Complications of Diabetes Mellitus Conduct Clinical Trials Data Diabetes Mellitus Disparity Education Educational Materials Endocrinologist Epidemiology Evidence based intervention Feedback Focus Groups Glycosylated hemoglobin A Goals Health Technology High Prevalence Individual Insulin Intervention Interview Language Latin America Latino Latino Population Mentored Patient-Oriented Research Career Development Award Mentors Methods National Institute of Diabetes and Digestive and Kidney Diseases Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Outcome Participant Patient Self-Report Patients Perception Pharmaceutical Preparations Physicians Population Prevalence Randomized, Controlled Trials Reporting Research Research Personnel Research Training Self Care Self Efficacy Strategic Planning System Testing Text Messaging Therapeutic Time Training United States Work behavioral adherence career clinically relevant comparison control cost diabetes management diabetes self-management digital health disparity reduction effectiveness/implementation trial ethnic minority ethnic minority population health communication improved improved outcome innovation interest intervention refinement live text mHealth medication compliance medication nonadherence patient engagement patient oriented patient portal response retention rate secondary outcome social disparities standard of care therapy development tool two way texting usability

项目摘要

PROJECT SUMMARY Background: Latino adults have a disproportionate burden of type 2 diabetes and diabetes-related complications. Diabetes medication non-adherence is an important modifiable contributor to suboptimal glycemic management among Latino adults, who are nearly twice as likely to report non-adherence to diabetes medications as non-Hispanic White individuals. Besides language barriers, additional commonly reported barriers that contribute to non-adherence in this population include negative perceptions about insulin use and misunderstanding ongoing need for diabetes medications once HbA1c has improved. Mobile health (mHealth) technology can reduce medication adherence barriers and improve adherence behavior, but mHealth tools that address commonly reported barriers to diabetes medication adherence among Latino adults are lacking. Candidate: I am an endocrinologist born and raised in Latin America; my long-term career goal is to develop scalable, patient-centered interventions that address gaps in diabetes self-care to improve outcomes among Latino adults with type 2 diabetes. Training: I have received outstanding research training in epidemiology but to achieve my long-term career goal I require additional training in: 1) adaptation of evidence-based interventions, 2) mixed methods, and 3) conduct of clinical trials in mHealth. Mentors: My training and research plans will be overseen by Primary Mentor Dr. Deborah Wexler (type 2 diabetes clinical trials/intervention adaptation) and Co-Mentor Dr. Lindsay Mayberry (mixed methodologist/mHealth clinical trials). Drs. Margarita Alegria (behavioral intervention adaptation to a Latino population), Enrique Caballero (cultural tailoring of diabetes interventions to a Latino population), J. Jaime Miranda (mHealth intervention development/testing in Latino populations), and Tanayott Thaweethai (biostatistics) will provide additional focused expertise. Research: I will adapt REACH, a text message-based mHealth platform with content tailored to address self-reported barriers to diabetes medication adherence (developed by Dr. Mayberry), to a Latino population (REACH-Español) with type 2 diabetes through two specific aims. Aim 1: Adapt and develop REACH-Es content on barriers to diabetes medication adherence with engagement of a diverse group of stakeholders (n=8), qualitative input from Latino adults with type 2 diabetes (n=20-30), and beta testing for intervention refinement with stakeholder input. Aim 2: Conduct a pilot RCT (n=70) to assess feasibility, acceptability, and usability of REACH-Es, as well as intervention targets (diabetes medication adherence and barriers to adherence) comparing REACH-Es to control; secondary outcomes are HbA1c and diabetes self- efficacy. The project will generate preliminary data for an R01 hybrid-effectiveness implementation trial of REACH-Es. The completion of these training and scientific aims will facilitate my transition to becoming an independent physician-investigator focused on developing scalable, patient-centered interventions that address gaps in diabetes self-care to improve outcomes among Latino adults with type 2 diabetes.

项目摘要背景：拉丁裔成年人的2型糖尿病和与糖尿病有关并发症。糖尿病药物不遵守是次优的重要促进者拉丁裔成年人的血糖管理几乎是糖尿病不遵守的两倍作为非西班牙裔白人的药物。除语言障碍外，其他常见的报告导致该人群不遵守的障碍包括对使用胰岛素使用和一旦HBA1C改善，误解了对糖尿病药物的持续需求。移动健康（MHealth）技术可以减少药物依从性障碍并改善依从性行为，但是MHealth工具在拉丁裔成年人中缺乏解决糖尿病药物依从性的普遍报道的障碍。候选人：我是一位在拉丁美洲出生和长大的内分泌学家；我的长期职业目标是发展可扩展的，以患者为中心的干预措施，解决糖尿病自我护理差距以改善结果有2型糖尿病的拉丁裔成年人。培训：我接受了流行病学的出色研究培训，但是为了实现我的长期职业目标，我需要在以下方面进行其他培训：1）适应基于证据的干预措施，2）混合方法和3）在MHealth中进行临床试验。导师：我的培训和研究计划将由主要导师Deborah Wexler博士（2型糖尿病临床）监督试验/干预适应）和同事Lindsay Mayberry博士（混合方法学家/MHealth临床试验）。博士。玛格丽塔·阿勒格里亚（Margarita Alegria）（行为干预适应拉丁裔人口），Enrique Caballero （糖尿病的文化剪裁对拉丁裔人口的干预措施），J。JaimeMiranda（MHealth干预）拉丁裔人口的开发/测试）和塔纳亚特·塔威泰（Tanayatt Thaweethai）（生物统计学）将提供额外的集中专业知识。研究：我将适应一个基于短信的MHealth平台，具有内容为解决糖尿病药物依从性（由Mayberry博士开发）的自我报告障碍而量身定制的拉丁裔人口（REACH-ESPAñol）具有2型糖尿病，通过两个特定目标。目标1：适应和发展涉及糖尿病药物遵守障碍的内容与潜水员的参与利益相关者（n = 8），来自2型糖尿病的拉丁裔成年人的定性输入（n = 20-30）和β测试利益相关者输入的干预完善。目标2：进行试验RCT（n = 70）以评估可行性，可接受性和可用性以及干预目标（糖尿病药物依从性和依从性的障碍）比较接触符的控制；次要结果是HBA1C和糖尿病自我效率。该项目将为R01混合效应实施试验生成初步数据到达-es。这些培训和科学目标的完成将有助于我过渡到成为一个独立的物理评估者的重点是开发可扩展的，以患者为中心的干预措施解决糖尿病自我护理中的差距，以改善2型糖尿病的拉丁裔成年人的预后。