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

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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.