Better Together: Leveraging primary care and social network resources to create a patient-centered approach to improve diabetes among immigrant communities

更好地在一起：利用初级保健和社交网络资源创建以患者为中心的方法来改善移民社区的糖尿病

• 批准号: 10589073
• 负责人: Megha Shah
• 金额: $ 15.24万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-19 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10589073
• 关键词: Address; Adopted; Affect; Africa; African; Asia; Award; Behavior; Behavior assessment; Belief; Biometry; Blood Pressure; Body Weight; Calories; Child; Clinic; Clinic Visits; Clinical Sciences; Communities; Data; Dedications; Development Plans; Diabetes Mellitus; Diet; Diffusion; Education; Educational Curriculum; European; Evaluation; Family; Family Practice; Family member; Focus Groups; Friends; Funding; Gender; Generations; Glycosylated Hemoglobin; Goals; Grant; Habits; Health; Health Services Accessibility; Health behavior; Health education; Health system; High Prevalence; Home; Immigrant; Immigrant community; Individual; Intervention; K-Series Research Career Programs; Latino Population; Life Cycle Stages; Life Style; Lipids; Manuscripts; Maps; Measurement; Minority; Modeling; Morbidity - disease rate; Motivation; Muslim population group; Native Americans; Native-Born; Natural experiment; Network-based; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Pathway Analysis; Patient Recruitments; Patients; Perception; Physical activity; Pilot Projects; Plasma; Population; Prediabetes syndrome; Primary Care; Protocols documentation; Research; Resources; Role; Rural; Scientist; Site; Social Network; South African; South Asian; Spouses; Testing; Training; Translational Research; Underrepresented Populations; Vulnerable Populations; Weight; Weight maintenance regimen; Woman; Work; Writing; acceptability and feasibility; behavior change; behavioral outcome; career; career development; clinical care; clinical practice; cost; data hub; design; diabetes risk; diabetes self-management; disparity reduction; epidemiologic data; ethnic minority; evidence base; experience; glycemic control; group intervention; health care disparity; health outcome disparity; healthy lifestyle; high risk; high risk population; hypertension control; implementation science; improved; innovation; intervention program; lifestyle factors; lifestyle intervention; male; medical appointment; member; men; mortality; patient oriented; patient population; peer; personalized care; preference; prevent; primary care setting; primary outcome; programs; recruit; satisfaction; secondary outcome; skills; social; translational study; uptake

PROJECT SUMMARY The long-term objective of this project is to improve the reach and uptake of evidence-based lifestyle programs to reduce disparities in diabetes (T2D) related outcomes among immigrant men. The study will explore the role of social networks, defined as family and peers, to support healthy lifestyle behaviors among immigrant men through the shared medical appointment model and to understand the diffusion of health behaviors amongst participants’ social networks. The aims are to: (1a & 1b) Qualitatively explore perceptions and cultural preferences for a clinic-based shared medical appointment intensive lifestyle intervention to inform program adaptation; (2) Conduct a pilot study to evaluate the feasibility and acceptability of social network- based (participant + social partner) versus individual-based (participant only) SMA ILI among South Asian and West African immigrant participants with prediabetes/T2D; and (3) Assess the behavioral outcomes of the pilot intervention amongst members of participants’ social networks to determine if there are spillover effects. The project will prepare Dr. Shah to transition to an independent clinician scientist using innovative health system- based models to leverage family and social networks to improve health outcomes and reduce disparities among vulnerable populations. Her career development plan includes these training goals to: (1) Gain skills in cultural adaptation of an intervention to reduce prediabetes/T2D; (2) Develop expertise in pragmatic evaluation design, protocols, and analysis; (3) Obtain advanced skills in social network analysis; and (4) Advance skills in presentation, manuscript and grant-writing. The research will be conducted in the primary care setting of the Emory Family Medicine Center in Dunwoody, GA, which serves a diverse patient population and is the site of Dr. Shah’s clinical practice. This K23 Career Development Award will also leverage the training resources of the Georgia Clinical and Translational Science Alliance. Results from this project will provide pilot data for an R01/R18 application to further evaluate the reach and uptake of culturally adapted lifestyle interventions for immigrant men with prediabetes and type 2 diabetes, an underrepresented group in current translational studies to date.

项目摘要 该项目的长期目标是提高循证生活方式项目的覆盖率和吸收率 减少移民男性之间糖尿病（T2 D）相关结果的差异。该研究将探讨 社交网络的作用，定义为家庭和同龄人，以支持移民健康的生活方式行为 男性通过共享医疗预约模式，了解健康行为的扩散 在参与者的社交网络中。目标是：（1a和1b）质量研究探索感知， 文化偏好的诊所为基础的共享医疗预约密集的生活方式干预，以告知 （2）开展试点研究，评估社会网络的可行性和可接受性- 南亚人群中基于（受试者+社会伴侣）与基于个人（仅受试者）的SMA ILI， 患有前驱糖尿病/T2 D的西非移民参与者;（3）评估试点的行为结果 在参与者的社交网络成员之间进行干预，以确定是否存在溢出效应。的 项目将准备沙阿博士过渡到一个独立的临床科学家使用创新的卫生系统- 利用家庭和社交网络改善健康成果和减少差距的模式 在弱势群体中。她的职业发展计划包括以下培训目标：（1）获得以下技能： 对减少糖尿病前期/T2 D的干预措施进行文化适应;（2）发展实用评估方面的专业知识 设计，协议和分析;（3）获得社会网络分析的高级技能;（4）提高 演讲、手稿和资助写作。这项研究将在初级保健环境中进行， 位于佐治亚州邓伍迪的埃默里家庭医学中心，为多样化的患者群体提供服务， 博士Shah的临床实践K23职业发展奖还将利用 格鲁吉亚临床和转化科学联盟。该项目的结果将为一个 R 01/R18应用，以进一步评估适应文化的生活方式干预措施的覆盖面和吸收情况， 患有前驱糖尿病和2型糖尿病的移民男性，在目前的翻译中代表性不足的群体 研究至今。