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

DM-BOOST para Latinx：利用行为经济学优化拉丁裔患者的外展和自我管理支持的糖尿病计划

• 批准号: 10525459
• 负责人: Daniel John Amante
• 金额: $ 16.51万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10525459
• 关键词: Address; Adherence; Adult; Affect; Appointments and Schedules; Architecture; Award; Behavior; Behavior Therapy; Caring; Chronic Disease; Clinical; Clinical Research; Collaborations; Communities; Community Health; Competence; Decision Making; Development; Diabetes Mellitus; Distress; Doctor of Philosophy; Education; Educational Intervention; Effectiveness; Evaluation; Extended Family; Face; Foundations; Fright; Funding; Future; Glycosylated hemoglobin A; Goals; Guidelines; Health; Healthcare Systems; High Prevalence; Human; Intention; Intervention; Interview; K-Series Research Career Programs; Knowledge; Language; Latinx; Latinx population; Limited English Proficiency; Marketing; Medical; Medicare; Mentored Research Scientist Development Award; Mentors; Mentorship; Modeling; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Overweight; Patient Outcomes Assessments; Patients; Pattern; Physicians; Population; Positioning Attribute; Process; Provider; Questionnaires; Randomized; Recommendation; Research; Research Training; Risk; Schedule; Science; Scientist; Self Care; Self Efficacy; Self Management; Self-control as a personality trait; Specialist; Technology; Testing; Training; Translating; Transportation; Underserved Population; Uninsured; United States National Institutes of Health; Work; acceptability and feasibility; barrier to care; base; behavior change; behavioral economics; behavioral health; beneficiary; care systems; career; clinical encounter; community engagement; consumer behavior; design; diabetes management; diabetes self-management; evidence base; evidence based guidelines; experience; financial incentive; health care delivery; health information technology; implementation barriers; implementation evaluation; improved; innovation; iterative design; outreach; patient engagement; patient population; peer; personalized intervention; preference; process evaluation; programs; satisfaction; skills; social; social health determinants; telehealth; theories; therapy design; treatment as usual; uptake; usability; virtual

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.

1 摘要 2 NIH 指导研究科学家发展 K01 奖的申请提出了一项专门的 Daniel J. Amante 博士（博士、公共卫生硕士）开启独立研究生涯的 3 条经验。他将专注于 4 实施基于技术的行为干预措施，以提高医疗保健服务的有效性和 5 2 型糖尿病 (T2D) 的管理。拟议的三年经验 1.) 建立在令人兴奋的基础上 6 工作基础，2.) 解决临床需求（提高糖尿病自我治疗的参与度和交付） 7 管理培训）和 3.） 是根据临床、社区和患者利益相关者的意见提供的。 8 慢性病的管理具有挑战性，特别是对于患有许多竞争性疾病的 T2D 患者而言 9健康要求。许多 T2D 管理都发生在临床之外，需要熟练的患者 10项自我护理技能。目前的循证指南建议糖尿病自我管理培训（DSMT） 11 全部 T2D 患者。 DSMT 通过认证为患者提供更多的访问和个性化支持 12 名糖尿病护理和教育专家。然而，DSMT 面临着重大的实施挑战 13 少数患者完成培训。拉丁裔患者是受 T2D 影响不成比例的人群，完成 14 DSMT 费率特别低。根据文化量身定制的干预措施旨在提高 DSMT 的参与度 需要 15 个此类服务不足的人群，才能避免与糖尿病相关的负面结果。 16 为了加强 DMST 的实施，Amante 博士开发了 DM-BOOST（糖尿病计划，使用 17 通过技术优化外展和自我管理支持的行为经济学）。 DM 的目标- 18 BOOST 将利用行为经济学的启发，提高患者对 DMST 的参与度和体验， 19 种技术辅助方法。 DM-BOOST 是为讲英语的患者开发的，但需要 20 针对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面和影响力。 21 该项目的具体目标是在文化上适应拉丁裔患者的 DM-BOOST，可用性测试“DM- 22 BOOST para Latinx’ 优化文化适宜性和患者参与度并进行可行性研究 23 DM-BOOST 对拉丁语的评估。这些目标将通过基于社区的参与来实现 24 与临床、社区和患者合作伙伴合作的研究方法。该项目将告知 25 个后续提案，旨在评估 DM-BOOST 在麻省大学纪念医疗保健系统中的实施情况。 26 为了实现这些目标，Amante 博士将接受专家导师的指导并接受以下方面的专门培训： 27 1.) 针对拉丁裔患者的糖尿病自我管理培训干预措施的文化适应，2.) 创新 28 用户体验，以优化面向患者的健康信息技术的使用，以及 3.) 实施 29 科学促进循证糖尿病护理服务的采用。该职业发展奖将 30 由专家导师指导并与 Amante 博士的临床、社区和患者合作伙伴合作。