Stories for Change (S4C): Digital Storytelling for Diabetes Self-Management among Hispanic Adults

变革故事 (S4C)：西班牙裔成人糖尿病自我管理的数字故事讲述

• 批准号: 9518279
• 负责人: IRENE G SIA
• 金额: $ 42.96万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-19 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9518279
• 关键词: Address; Adult; Affect; Age; Area; Arizona; Attitude; Behavior; Behavioral; Belief; Blood Glucose; Blood Glucose Self-Monitoring; Blood Pressure; Body mass index; Caring; Chronic Disease; Cognitive; Communities; Community Health; Community Participation; Complex; Data; Diabetes Mellitus; Diet; Disease; Disease Management; Educational workshop; Expectancy; Glycosylated hemoglobin A; Health; Health Priorities; Health Promotion; Health Services; Health behavior; Healthcare; Hispanics; Human Resources; Hypertension; Immigrant; Individual; Institution; Intervention; LDL Cholesterol Lipoproteins; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Methods; Minnesota; Modeling; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Outcome Assessment; Outcome Measure; Participant; Patients; Phase; Physical activity; Population; Primary Health Care; Process; Production; Randomized; Randomized Controlled Trials; Research; Research Infrastructure; Self Efficacy; Self Management; Shapes; Smoking; Social support; Socioeconomic Status; Surface; Testing; Time; Translations; Transportation; Voice; Vulnerable Populations; Work; base; behavior change; behavior influence; clinical care; community based participatory research; community partnership; comparison group; design; diabetes education; digital; experience; glucose monitor; glycemic control; group intervention; health disparity; improved; improved outcome; innovation; intervention cost; intervention effect; medication compliance; primary care setting; primary outcome; randomized trial; resource guides; secondary outcome; service organization; sex; social; social cognitive theory; theories; therapy design; therapy development; treatment as usual

PROJECT SUMMARY/ABSTRACT Hispanic adults are twice as likely to have type 2 diabetes mellitus (T2D) and 1.5 times more likely to die from the disease than non-Hispanic whites. These disparities are mediated, in part, by less healthful levels of physical activity, dietary quality, medication adherence, and self-monitoring of blood glucose than non-Hispanic whites. Given the complex sociocultural forces that influence these behaviors, a community-based participatory research (CBPR) approach is called for to address them. The Rochester Healthy Community Partnership is a robust CBPR partnership consisting of community-based organizations, health service organizations, and academics who are experienced at collectively deploying programming and outcomes assessment among immigrant populations. Over the past three years, RHCP partners from the Hispanic community have co- created a digital storytelling intervention for T2D self-management that has been piloted in primary care settings across multiple institutions. Digital storytelling interventions are narrative-based videos elicited through a CBPR approach to surface the authentic voices of participants overcoming obstacles to health promoting behaviors, in this case, behaviors related to diabetes self-management (physical activity, healthful diet, medication adherence, and blood glucose monitoring). These videos can shape health behaviors of viewers through influences on attitudes and beliefs. The aims are: 1) To evaluate the efficacy of a community- derived digital storytelling intervention among Hispanic adults with poorly controlled T2D, and 2) to explore the effect of the intervention on proposed theory-based mediators of change. Using a two-group design, 450 Hispanic adults with poorly controlled T2D will be randomly assigned to view the 12-minute digital storytelling intervention with usual care or receive usual clinical care only. Both groups will receive diabetes education materials and a resource guide for contacting their diabetes care team, consistent with existing standards of care. The primary outcome, measured up to six months after intervention delivery, will be glycemic control as measured by hemoglobin A1c. Secondary outcomes will include diabetes self-management behaviors, blood pressure, LDL-cholesterol, and body mass index. The impact of concomitant covariates, including sex, age, and socio-economic status, on the sensitivity of the intervention effect will also be explored. This work tests a scalable, low cost intervention targeting vulnerable populations implemented in primary care settings with the opportunity for rapid translation to practice. We will establish a disseminable framework for community participation in digital storytelling production for chronic disease management, providing a model that may be applied to other communities and health priorities.

项目摘要/摘要 西班牙裔成年人患有2型糖尿病（T2D）的可能性是死于2型糖尿病（T2D）的两倍，死亡的可能性高1.5倍 该疾病比非西班牙裔白人。这些差异是由健康水平较低的部分介导的 与非西班牙裔相比 白人。鉴于影响这些行为的复杂社会文化力量，这是一个基于社区的参与性 需要研究（CBPR）方法来解决这些方法。罗切斯特健康社区伙伴关系是 强大的CBPR合作伙伴关系由社区组织，卫生服务组织和 在共同部署编程和成果评估方面经验丰富的学术界 移民人口。在过去的三年中，来自西班牙裔社区的RHCP合作伙伴共同 为T2D自我管理创建了数字故事干预，该干预已在初级保健中进行了试验 跨多个机构的设置。数字讲故事干预措施是基于叙事的视频 通过CBPR的方法，浮出水面的正宗声音克服了健康的障碍 在这种情况下，促进行为与糖尿病自我管理有关（体育活动，健康 饮食，药物依从性和血糖监测）。这些视频可以塑造 观众通过影响态度和信念的影响。目的是：1）评估社区的功效 - 在控制不良的西班牙裔成年人中，衍生的数字讲故事干预，2）探索 干预对拟议的基于理论的变革中的调解人的影响。使用两组设计，450 控制不良的T2D的西班牙裔成年人将被随机分配以查看12分钟的数字故事讲述 干预通常护理或仅接受通常的临床护理。两组将接受糖尿病教育 材料和与糖尿病护理团队联系的资源指南，与现有标准一致 关心。干预后最多六个月测量的主要结果将是血糖控制 通过血红蛋白A1c测量。次要结果将包括糖尿病的自我管理行为，血液 压力，LDL-胆固醇和体重指数。伴随的协变量的影响，包括性别，年龄， 还将探讨有关干预效果的敏感性的社会经济地位。这项工作测试 可扩展的低成本干预针对针对初级保健环境中实施的脆弱人群 快速翻译练习的机会。我们将为社区建立一个可分配的框架 参与慢性病管理的数字故事生产，提供了一种模型 应用于其他社区和健康优先事项。