A Mobile Health Intervention to Reduce Diabetes Disparities in Chinese Americans

减少华裔美国人糖尿病差异的移动健康干预措施

• 批准号: 9769129
• 负责人: Lu Hu
• 金额: $ 10.34万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-23 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769129
• 关键词: Address; Adult; Asian Americans; Award; Behavior; Behavior Therapy; Behavioral; Behavioral Sciences; Caring; Chinese American; Chinese People; Chronic Disease; Clinical; Clinical Trials; Communication Barriers; Communities; Control Groups; Counseling; Data; Development; Diabetes Mellitus; Dietary intake; Disease Outcome; Economics; Education; Effectiveness; Evaluation; Evidence based intervention; Glycosylated hemoglobin A; Goals; Health; Health Personnel; Healthcare Systems; High Prevalence; Hispanic Americans; Home environment; Hypertension; Immigrant; International; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Kidney; Knowledge; Language; Life Style; Life Style Modification; Limited English Proficiency; Linguistics; Link; Measurement; Methods; Minority; Minority Groups; Mission; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Participant; Pathway interactions; Patients; Phase; Physical activity; Play; Population; Population Growth; Pre-Post Tests; Prediabetes syndrome; Prevalence; Prevention; Public Health; Qualitative Research; Randomized; Randomized Controlled Trials; Report (document); Research; Research Design; Research Personnel; Risk; Role; Self Efficacy; Self Management; South Asian; Testing; Text Messaging; Time; Training; Underserved Population; United States; Waiting Lists; Work; arm; base; care outcomes; community based participatory research; cost; diabetes control; diabetes education; diabetes management; disparity reduction; efficacy trial; ethnic minority population; glycemic control; health care availability; health disparity; high risk; improved; intervention program; mHealth; middle age; minority health; mobile computing; patient-clinician communication; primary outcome; programs; psychosocial; public health relevance; secondary outcome; service intervention; skills; standard of care

PROJECT SUMMARY/ABSTRACT Chinese Americans are one of the fastest growing immigrant groups in the US, who suffer disproportionately high type 2 diabetes (T2D) burden and have poorly controlled T2D. Despite the well-documented T2D disparities in this minority group, limited work has been conducted to improve health outcomes in Chinese Americans. The goal of this Pathway to Independence Award (K99/R00) is to expedite the candidate's transition to an independent investigator who possesses focused expertise in development and evaluation of culturally and linguistically tailored and sustainable interventions to reduce T2D disparities in Chinese Americans. In the K99 phase of this award, the candidate will obtain critical training needed to accomplish this goal and will develop a short message service (SMS) intervention to improve T2D management in Chinese Americans. In the R00 phase, the candidate will utilize acquired skills to conduct a pilot randomized controlled trial to examine the potential efficacy of the SMS intervention. In the K99 phase, the candidate will also conduct pilot work to develop linguistically and culturally tailored SMS intervention content and to refine the intervention to be tested in the R00 phase. More specifically, the aims are to 1) characterize barriers and facilitators of glycemic control in Chinese Americans with T2D (Aim 1a); 2) develop culturally and linguistically tailored SMS intervention content (Aim 1b); and 3) assess the feasibility and acceptability of the SMS intervention in a pre-, post-test study (Aim 1c). In the R00 phase, the candidate will refine the SMS intervention based on the K99 pilot data and evaluate the proof-of-concept regarding its efficacy in a pilot randomized controlled trial among 66 Chinese Americans with T2D (Aim 2). Participants will be randomized to one of 2 arms (n=33 each): 1) wait-list control and 2) SMS intervention. Both groups will continue to receive standard of care treatment for their T2D. The SMS group will receive brief lifestyle counseling videos via SMS links. At the end of the study, the wait-list control group will be provided the opportunity to receive the SMS-based counseling videos. Measurements will be obtained at baseline, 3, and 6 months. The primary outcome is HbA1c and secondary outcomes include self-efficacy, diabetes self-management behaviors, dietary intake and physical activity behaviors. Linear mixed modeling will be used to examine the group and group by time interaction effects between the SMS intervention and wait-list control group. Findings from this R00 study will inform a larger full-scale R01 efficacy trial of the SMS intervention, and ultimately, establish the candidate's program of research focused on developing and testing sustainable interventions to reduce disparities in chronic disease outcomes in Chinese Americans. This project can serve as a program model for other chronic disease interventions in Chinese Americans that require lifestyle modification (e.g., prediabetes, hypertension), or for disparities research in other high-risk immigrant populations (e.g., South Asians, Hispanic Americans).

项目摘要/摘要 华裔美国人是美国成长最快的移民群体之一，他们遭受不成比例的 高型2糖尿病（T2D）负担，T2D控制不善。尽管有据可查的T2D 在这个少数群体中，已经进行了有限的工作以改善中国的健康状况 美国人。这一获得独立奖的目标（K99/R00）是加快候选人的加快 过渡到具有在开发和评估方面具有重点专业知识的独立调查员 在文化和语言上量身定制和可持续的干预措施，以减少中国的T2D差异 美国人。在该奖项的K99阶段，候选人将获得完成此项培训所需的关键培训 目标并将开发简短的消息服务（SMS）干预措施，以改善中文的T2D管理 美国人。在R00阶段，候选人将利用获得的技能进行飞行员随机控制 试验以检查SMS干预的潜在功效。在K99阶段，候选人也将 进行试点工作，以语言和文化量身定制的SMS干预含量并完善 干预措施将在R00阶段进行测试。更具体地说，目的是1）表征障碍和 具有T2D的华裔美国人血糖控制的促进者（AIM 1A）； 2）在文化和语言上发展 量身定制的SMS干预内容（AIM 1B）； 3）评估SMS的可行性和可接受性 干预测试前研究（AIM 1C）。在R00阶段，候选人将完善SMS干预 基于K99试验数据，并评估概念概念的验证，以便在随机的飞行员中进行疗效 66名具有T2D的中国美国人的对照试验（AIM 2）。参与者将被随机分为2个 臂（n = 33）：1）等待名单控制和2）SMS干预。两组将继续获得标准 他们的T2D护理治疗。 SMS小组将通过SMS链接获得简短的生活方式咨询视频。在 研究的结尾，将为等待名单对照组提供接收基于SMS的机会 咨询视频。测量将在基线，3和6个月时获得。主要结果是 HBA1C和次要结果包括自我效能感，糖尿病自我管理行为，饮食摄入和 身体活动行为。线性混合建模将用于按时间检查组和组 SMS干预和候补名单对照组之间的相互作用效应。这项R00研究的发现将 告知SMS干预的更大的全尺度R01功效试验，并最终建立候选人的 研究计划的重点是制定和测试可持续干预措施，以减少差异 华裔美国人的慢性疾病结果。该项目可以作为其他慢性的计划模型 需要改变生活方式的中国美国人的疾病干预措施（例如，糖尿病前，高血压）， 或用于其他高风险移民人口（例如南亚人，西班牙裔美国人）的差异研究。