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

在数字讲故事干预中影响拉丁裔个体血糖控制和 2 型糖尿病自我管理行为积极变化的因素：一项混合方法研究

• 批准号: 10675951
• 负责人: Abby Lohr
• 金额: $ 7.16万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-12-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675951
• 关键词: Acceleration; Address; Adopted; Age; Area; Attitude; Behavior; Blood Pressure; Body mass index; Characteristics; Chronic; Chronic Disease; Clinical; Collaborations; Communities; Data; Development; Diabetes Mellitus; Disease; Disparity; Education; Equilibrium; Evaluation; Exposure to; Feeling; Foundations; Funding; Future; Gender; Glucose; Glycosylated hemoglobin A; Goals; HIV; Health; Health Benefit; Health Disparities Research; Health Promotion; Healthcare; Hispanic Americans; Hispanic Populations; Individual; Inequity; Intervention; Interview; Investigation; Joints; K-Series Research Career Programs; Knowledge; LDL Cholesterol Lipoproteins; Latinx; Latinx population; Malignant Neoplasms; Mentors; Methods; Mission; Modeling; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Participant; Patients; Persons; Physical activity; Pilot Projects; Policies; Population; Public Health; Publications; Qualitative Methods; Reduce health disparities; Research; Research Design; Resources; Risk Factors; Scientist; Self Efficacy; Self Management; Social support; Structure; Testing; Training; Translating; Transportation; Treatment Efficacy; United States National Institutes of Health; Work; behavior change; behavior influence; behavioral outcome; care outcomes; career; clinical practice; cohort; community based participatory research; community partnership; comparison intervention; diabetes self-management; didactic education; dietary; digital; disease disparity; disparity elimination; disparity reduction; experience; food insecurity; glycemic control; health equity; health literacy; improved; insight; interest; marginalized population; medication compliance; resilience; response; skills; social cognitive theory; social culture; sociodemographic factors; sociodemographics; structural determinants; theories

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.

项目摘要/摘要 西班牙裔美国人不成比例地受到2型糖尿病（T2 D）的影响，部分原因是结构性因素 导致较低的体力活动水平，饮食质量，药物依从性和葡萄糖自我监测， 非西班牙裔白色人群。为了消除这些差异，需要采取符合文化特点的干预措施， 接受健康的行为和改善T2 D的结果是必要的。有一种干预有可能 成功的关键是数字讲故事（DST）（由个人创作的基于叙事的视频， 在特定疾病经历的背景下讲述）。叙述方法（包括DST）， 事实证明，社区观点比说教式教育更能影响人们的态度。 通过DST干预，参与者获得了告知行为改变的知识，这反过来又增强了 他们的医疗保健成果和减少疾病。除了两项试点研究外，DST干预措施还没有得到实施。 先前与患有T2 D或其他慢性疾病的Latinx个体进行了测试。此外，尚不清楚是否 以及个体特征或疾病类型如何影响个体对定制数字化的反应， 故事因此，本指导F32提案的总体目标是评估DST的影响 干预受社会人口学因素的影响，如年龄、性别、社会支持、知识和T2 D 拉丁裔人群的疾病特征。申请人Abby Lohr博士曾在 使用基于社区的参与性研究方法来解决慢性病的差异 拉丁裔人口。Lohr博士感兴趣的是确定方法来定制DST干预措施，以解决健康问题。 在历史上被边缘化的人群中。Lohr博士和她的指导团队创建了一个全面的 培训计划，将建立在她以前的经验，并扩大她的知识和技能，在新的领域。博士 Lohr的培训目标是：1）推进特定的混合方法技能和理论应用， 健康公平研究; 2）加速DST的内容专业知识; 3）深化健康公平的专业知识 从机械基础到将糖尿病相关健康差异研究转化为政策的原则 和临床实践。为了实现这些目标，Lohr博士提出了一种混合方法研究， 解释哪些社会人口统计学因素和基线T2 D指标会影响拉丁裔个体对 DST干预。这项工作建立在变革故事（S4 C）（5 R 01 DK 113999 -03）的基础上， 拉丁社区合作伙伴和罗切斯特健康社区伙伴关系之间的研究工作。成功 这项研究的完成将导致第一作者的出版物，以及产生关键的初步数据 需要支持竞争性K奖申请。总的来说，这种集中的培训，研究经验， 社区和学术合作的建立将支持Lohr博士的职业生涯和专业 发展，让她发展的基础，从她可以追求一个成功的职业生涯， 独立资助的科学家专注于旨在减少糖尿病负担差异的研究。