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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要/摘要西班牙裔成年人患 2 型糖尿病 (T2D) 的可能性是普通人的两倍，死于糖尿病的可能性是普通人的 1.5 倍这种疾病的发病率高于非西班牙裔白人。这些差异在一定程度上是由不健康水平造成的体力活动、饮食质量、药物依从性和血糖自我监测优于非西班牙裔白人。鉴于影响这些行为的复杂社会文化力量，基于社区的参与需要研究（CBPR）方法来解决这些问题。罗彻斯特健康社区合作伙伴关系是强大的 CBPR 伙伴关系由社区组织、卫生服务组织和具有集体部署规划和成果评估经验的学者移民人口。在过去的三年里，来自西班牙裔社区的 RHCP 合作伙伴共同创建了一种针对 T2D 自我管理的数字讲故事干预措施，并已在初级保健中进行试点跨多个机构的设置。数字叙事干预是基于叙事的视频引发的通过 CBPR 方法来表达参与者克服健康障碍的真实声音促进行为，在这种情况下，是与糖尿病自我管理相关的行为（体力活动、健康的饮食、药物依从性和血糖监测）。这些视频可以塑造健康行为通过对态度和信仰的影响来影响观众。目标是： 1) 评估社区的功效- 对患有 T2D 控制不佳的西班牙裔成年人进行数字化讲故事干预，以及 2) 探索干预对基于理论的变革中介的影响。采用两组设计，450 患有 T2D 控制不佳的西班牙裔成年人将被随机分配观看 12 分钟的数字故事讲述进行常规护理干预或仅接受常规临床护理。两组都将接受糖尿病教育与糖尿病护理团队联系的材料和资源指南，符合现有的糖尿病护理标准关心。主要结局在干预实施后六个月内进行测量，将是血糖控制，如下所示：通过血红蛋白 A1c 测量。次要结果包括糖尿病自我管理行为、血液压力、低密度脂蛋白胆固醇和体重指数。伴随协变量的影响，包括性别、年龄、社会经济地位对干预效果的敏感性也将进行探讨。这项工作测试了一个在初级保健机构中针对弱势群体实施可扩展、低成本的干预措施快速翻译练习的机会。我们将为社区建立一个可传播的框架参与慢性病管理的数字故事制作，提供了一个可能的模型适用于其他社区和卫生优先事项。