The Diabetes Clinical outcomes Associated with Retention and Engagement in Care, in Samoa (Diabetes CARE)

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Project Summary This proposal presents a five-year research career development award for Dr. Anna Rivara, an Associate Research Scientist (Yale's equivalent to Assistant Professor (Research)) in the Department of Chronic Disease Epidemiology at the Yale School of Public Health (YSPH). The proposal aims to address important issues surrounding the current epidemic of Type 2 Diabetes Mellitus (T2D) being experienced by Samoans and other Pacific Islanders. Project goals are to 1) examine preferences for diabetes care among adult Samoans recently diagnosed with diabetes using a discrete choice experiment, 2) prospectively estimate the associations between diabetes care and glycemic outcomes among adult Samoans, and 3) longitudinally assess diabetes care decision-making and coping strategies. Outcomes from this project will be integral to understanding and offering effective and acceptable treatment options to alleviate the burden of diabetes faced by Pacific Islander populations. The proposal describes a rigorous, mixed methods-based investigation that will be made possible through the advanced mentoring and training that the PI will receive throughout the award period. The proposed work will be conducted under primary mentors Dr. Nicola Hawley, Ph.D, Associate Professor of Epidemiology (Chronic Diseases) at YSPH, Dr. Leslie Curry, Ph.D., MPH, Professor of Health Policy at YSPH and Associate Director of the Yale Scholars in Implementation Science Training Program, and Dr. Satupaitea Viali, MBBS, MPH, of the National University of Samoa and the University of Otago. Additionally, collaborators Dr. Omar Galárraga, Ph.D, Associate Professor of Health Services, Policy and Practice at Brown University School of Public Health, Dr. Rochelle Rosen, Ph.D., Associate Professor of Behavioral and Social Sciences at The Miriam Hospital and Brown University, Dr. Erin Kershaw, Ph.D., MD., Associate Professor of Medicine at the University of Pittsburgh, and Dr. Jenna Carlson, Assistant Professor of Biostatistics and Human Genetics at the University of Pittsburgh, will be providing mentorship and hands-on training in research implementation, dissemination, and mixed methods analyses. Dr. Rivara's training goals are to 1) gain new skills in discrete choice experiments and longitudinal analytical approaches and advance skills in mixed methods data collection and mixed effects linear modeling; 2) strengthen professional development through preparation and submission of policy briefs and peer-reviewed manuscripts and science communication via presentation of results at invited seminars, and national and international conferences; and 3) advance skills in grantsmanship though didactic and applied training and the construction and submission of a diabetes-focused R01 intervention upon the completion of the award period. Together, the research outcomes and training will lay the foundations for Dr. Rivara's career developing culturally sensitive, participant-guided interventions in low resource settings as a diabetes-focused health services researcher.