Factors influencing positive change in glycemic control and Type 2 diabetes self-management behavior among Latinx individuals in a digital storytelling intervention: A mixed-methods study

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PROJECT SUMMARY/ABSTRACT Hispanic Americans are disproportionately impacted by type 2 diabetes (T2D) due, in part, to structural factors that lead to lower physical activity levels, dietary quality, medication adherence, and glucose self-monitoring than Non-Hispanic White populations. To eliminate these disparities, culturally tailored interventions that enhance acceptance of healthy behaviors and improve T2D outcomes are needed. One intervention that has the potential to be successful is digital storytelling (DST) (narrative-based videos created by individuals who have a story to tell in the context of a particular disease experience). Narrative approaches (including DST) that incorporate community perspectives have been shown to influence attitudes more powerfully than didactic education. Through DST interventions, participants gain knowledge that informs behavior change which in turn enhances their healthcare outcomes and reduces illness. Apart from two pilot studies, DST interventions have not been tested previously with Latinx individuals with T2D or other chronic conditions. Additionally, it is not known whether and how individual characteristics or disease type may influence how individuals respond to a tailored digital story. Therefore, the overall goal of this mentored F32 proposal is to evaluate how the impact of a DST intervention is influenced by sociodemographic factors such as age, gender, social support, knowledge, and T2D disease characteristics among Latinx populations. The applicant, Dr. Abby Lohr, received graduate training in using a community-based participatory research approach to address chronic disease disparities experienced by Latinx populations. Dr. Lohr is interested in identifying methods to tailor DST interventions to address health concerns within historically marginalized populations. Dr. Lohr and her mentoring team created a comprehensive training plan that will build on her previous experience and expand her knowledge and skills in new areas. Dr. Lohr’s training objectives are to: 1) advance specific mixed methods skills and application of theory tailored to health equity research; 2) accelerate content expertise in DST; and 3) deepen expertise in health equity principles from mechanistic underpinnings to translating diabetes-related health disparities research to policy and clinical practice. To achieve these goals, Dr. Lohr has proposed a mixed methods study to identify and explain which sociodemographic factors and baseline T2D metrics influence how Latinx individuals respond to a DST intervention. This work builds upon Stories for Change (S4C) (5R01DK113999-03), a collaborative research effort between Latinx community partners and Rochester Healthy Community Partnership. Successful completion of this research will result in first-authored publications as well as generate critical preliminary data needed to support a competitive K award application. Collectively, this focused training, research experience, and the establishment of community and academic collaborations will support Dr. Lohr’s career and professional advancement and allow her to develop a foundation from which she can pursue a successful career as an independently funded scientist focused on research that aims to reduce disparities in diabetes burden.