DM-BOOST para Latinx: a Diabetes Mellitus program using Behavioral economics to Optimize Outreach and Self-management support with Technology for Latinx patients

1摘要 NIH指导研究科学家发展K01奖的这份申请书提出了一项专门的 3启动丹尼尔·J·阿曼特博士独立研究生涯的经验，博士，公共卫生硕士。他将专注于 4实施以技术为基础的行为干预，以提高医疗保健提供的有效性和 5 2型糖尿病(T2D)的管理。三年的拟议经验1.建立在激动人心的 6工作基础，2.)满足临床需求(提高糖尿病患者的参与度和自理能力 7管理培训)，以及3.)由临床、社区和患者利益相关者提供信息。 慢性疾病的管理是具有挑战性的，特别是对于患有T2D的患者来说，他们有许多竞争对手 9健康诉求。许多T2D管理发生在临床会诊之外，需要熟练的患者 10项自我照顾技能。目前的循证指南建议对以下患者进行糖尿病自我管理培训(DSMT 11例均为T2D患者。DSMT通过认证为患者提供更多的访问和个性化的支持 12名糖尿病护理和教育专家。然而，DSMT面临着巨大的实施挑战， 完成训练的患者很少。拉丁裔患者，受T2D影响不成比例的人群，完全 14 DSMT，费率特别低。文化上量身定制的干预措施，旨在增加与DSMT的接触 需要15个这样的服务不足的人群，才能避免与糖尿病相关的负面后果。 16为了加强DMST的实施，阿曼特博士开发了DM-Boost(糖尿病方案，使用 17行为经济学，以技术优化外联和自我管理支持)。DM的目标是- 18 Boost旨在使用行为经济学启发的方式提高患者对DMST的参与度和体验， 19种技术辅助的方法。DM-Boost是为说英语的患者开发的，但需要 20为讲西班牙语的拉丁裔患者进行文化调整，以扩大该计划的覆盖范围和影响。 21这个项目的具体目标是使DM-Boost在文化上适应Latinx患者，可用性测试‘DM-Boost 22促进Para Latinx，以优化文化适当性和患者参与度，并进行可行性 23对DM-Boost Para Latinx的评价。这些目标将通过以社区为基础的参与式 24与临床、社区和患者合作伙伴合作的研究方法。该项目将通知 25评估DM-Boost在加州大学马萨诸塞州纪念保健系统中的实施情况的后续提案。 26为实现这些目标，阿曼特博士将在专家导师的指导下，接受以下方面的专门培训： 27 1.)拉丁裔患者糖尿病自我管理训练干预的文化适应，2。创新： 28优化使用面向患者的健康信息技术的用户体验，以及3.)实施 29科学促进循证糖尿病护理服务的普及。这个职业发展奖将是 30由专家导师指导，并与阿曼特医生的临床、社区和患者合作伙伴合作。

1 ABSTRACT 2 This application for the NIH Mentored Research Scientist Development K01 Award proposes a specialized 3 experience to launch the independent research career of Dr. Daniel J. Amante, PhD, MPH. He will focus on 4 implementing technology-based behavioral interventions to improve the effectiveness of healthcare delivery and 5 management of type 2 diabetes (T2D). The three-year proposed experience 1.) builds upon an exciting 6 foundation of work, 2.) addresses a clinical need (improving engagement and delivery of diabetes self- 7 management training), and 3.) is informed by input from clinical, community and patient stakeholders. 8 Management of chronic diseases is challenging, especially for patients with T2D who have many competing 9 health demands. Much of T2D management occurs outside of clinical encounters, requiring proficient patient 10 self-care skills. Current evidence-based guidelines recommend diabetes self-management training (DSMT) for 11 all T2D patients. DSMT provides patients with increased access and personalization of support by certified 12 diabetes care and education specialists. DSMT faces significant implementation challenges, however, with very 13 few patients completing training. Latinx patients, a population disproportionately affected by T2D, complete 14 DSMT at especially low rates. Culturally-tailored interventions designed to increase engagement with DSMT in 15 such underserved populations are needed so that negative diabetes-related outcomes are averted. 16 To enhance implementation of DMST, Dr. Amante developed DM-BOOST (Diabetes Mellitus program using 17 Behavioral economics to Optimize Outreach and Self-management support with Technology). The goals of DM- 18 BOOST are to increase patient engagement and experience with DMST using Behavioral Economics-inspired, 19 technology-assisted approaches. DM-BOOST has been developed for English-speaking patients but needs to 20 be culturally-adapted for Spanish-speaking Latinx patients to increase the reach and impact of the program. 21 The specific aims of this project are to culturally adapt DM-BOOST for Latinx patients, usability test ‘DM- 22 BOOST para Latinx’ to optimize cultural appropriateness and patient engagement and conduct a feasibility 23 evaluation of DM-BOOST para Latinx. These aims will be accomplished via a community-based participatory 24 research approach in collaboration with clinical, community and patient partners. This project will inform 25 subsequent proposals to evaluate implementation of DM-BOOST in the UMass Memorial Health Care system. 26 To accomplish these aims, Dr. Amante will be guided by expert mentors and receive specialized training in: 27 1.) cultural adaption of diabetes self-management training interventions for Latinx patients, 2.) innovation with 28 user experience to optimize use of patient-facing health information technologies, and 3.) implementation 29 science to enhance uptake of evidence-based diabetes care services. This career development award will be 30 guided by expert mentors and in collaboration with Dr. Amante’s clinical, community and patient partners.