Factors influencing positive change in glycemic control and Type 2 diabetes self-management behavior among Latinx individuals in a digital storytelling intervention: A mixed-methods study

在数字讲故事干预中影响拉丁裔个体血糖控制和 2 型糖尿病自我管理行为积极变化的因素：一项混合方法研究

• 批准号: 10675951
• 负责人: Abby Lohr
• 金额: $ 7.16万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-12-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675951
• 关键词: Acceleration; Address; Adopted; Age; Area; Attitude; Behavior; Blood Pressure; Body mass index; Characteristics; Chronic; Chronic Disease; Clinical; Collaborations; Communities; Data; Development; Diabetes Mellitus; Disease; Disparity; Education; Equilibrium; Evaluation; Exposure to; Feeling; Foundations; Funding; Future; Gender; Glucose; Glycosylated hemoglobin A; Goals; HIV; Health; Health Benefit; Health Disparities Research; Health Promotion; Healthcare; Hispanic Americans; Hispanic Populations; Individual; Inequity; Intervention; Interview; Investigation; Joints; K-Series Research Career Programs; Knowledge; LDL Cholesterol Lipoproteins; Latinx; Latinx population; Malignant Neoplasms; Mentors; Methods; Mission; Modeling; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Participant; Patients; Persons; Physical activity; Pilot Projects; Policies; Population; Public Health; Publications; Qualitative Methods; Reduce health disparities; Research; Research Design; Resources; Risk Factors; Scientist; Self Efficacy; Self Management; Social support; Structure; Testing; Training; Translating; Transportation; Treatment Efficacy; United States National Institutes of Health; Work; behavior change; behavior influence; behavioral outcome; care outcomes; career; clinical practice; cohort; community based participatory research; community partnership; comparison intervention; diabetes self-management; didactic education; dietary; digital; disease disparity; disparity elimination; disparity reduction; experience; food insecurity; glycemic control; health equity; health literacy; improved; insight; interest; marginalized population; medication compliance; resilience; response; skills; social cognitive theory; social culture; sociodemographic factors; sociodemographics; structural determinants; theories

PROJECT SUMMARY/ABSTRACT Hispanic Americans are disproportionately impacted by type 2 diabetes (T2D) due, in part, to structural factors that lead to lower physical activity levels, dietary quality, medication adherence, and glucose self-monitoring than Non-Hispanic White populations. To eliminate these disparities, culturally tailored interventions that enhance acceptance of healthy behaviors and improve T2D outcomes are needed. One intervention that has the potential to be successful is digital storytelling (DST) (narrative-based videos created by individuals who have a story to tell in the context of a particular disease experience). Narrative approaches (including DST) that incorporate community perspectives have been shown to influence attitudes more powerfully than didactic education. Through DST interventions, participants gain knowledge that informs behavior change which in turn enhances their healthcare outcomes and reduces illness. Apart from two pilot studies, DST interventions have not been tested previously with Latinx individuals with T2D or other chronic conditions. Additionally, it is not known whether and how individual characteristics or disease type may influence how individuals respond to a tailored digital story. Therefore, the overall goal of this mentored F32 proposal is to evaluate how the impact of a DST intervention is influenced by sociodemographic factors such as age, gender, social support, knowledge, and T2D disease characteristics among Latinx populations. The applicant, Dr. Abby Lohr, received graduate training in using a community-based participatory research approach to address chronic disease disparities experienced by Latinx populations. Dr. Lohr is interested in identifying methods to tailor DST interventions to address health concerns within historically marginalized populations. Dr. Lohr and her mentoring team created a comprehensive training plan that will build on her previous experience and expand her knowledge and skills in new areas. Dr. Lohr’s training objectives are to: 1) advance specific mixed methods skills and application of theory tailored to health equity research; 2) accelerate content expertise in DST; and 3) deepen expertise in health equity principles from mechanistic underpinnings to translating diabetes-related health disparities research to policy and clinical practice. To achieve these goals, Dr. Lohr has proposed a mixed methods study to identify and explain which sociodemographic factors and baseline T2D metrics influence how Latinx individuals respond to a DST intervention. This work builds upon Stories for Change (S4C) (5R01DK113999-03), a collaborative research effort between Latinx community partners and Rochester Healthy Community Partnership. Successful completion of this research will result in first-authored publications as well as generate critical preliminary data needed to support a competitive K award application. Collectively, this focused training, research experience, and the establishment of community and academic collaborations will support Dr. Lohr’s career and professional advancement and allow her to develop a foundation from which she can pursue a successful career as an independently funded scientist focused on research that aims to reduce disparities in diabetes burden.

项目摘要/摘要 西班牙裔美国人受到2型糖尿病（T2D）的影响，部分原因是结构性因素 这会导致体育锻炼水平降低，饮食质量，药物依从性和葡萄糖自我监控，而不是 非西班牙裔白人种群。为了消除这些差异，文化量身定制的干预措施可以增强 需要接受健康行为并改善T2D结果。一种有潜力的干预措施 成功的是数字讲故事（DST）（由个人创建的基于叙事的视频 在特定疾病经历的背景下讲述）。叙事方法（包括DST） 与教学教育相比，社区观点已被证明对与会者的影响更大。 通过DST干预措施，参与者获得知识，以告知行为改变，这反过来又增强了 他们的医疗保健结果并减少了疾病。除了两项试点研究外，DST干预措施还没有 先前曾用具有T2D或其他慢性病的拉丁裔个体进行测试。另外，尚不知道是否 以及个人特征或疾病类型如何影响个人对量身定制数字的反应 故事。因此，该重要的F32提案的总体目标是评估DST的影响 干预受到社会人口统计学因素的影响，例如年龄，性别，社会支持，知识和T2D 拉丁人种群中的疾病特征。申请人艾比·洛尔（Abby Lohr）博士接受了研究生培训 使用基于社区的参与研究方法来解决经验丰富的慢性疾病分布 由拉丁人种群。 Lohr博士有兴趣确定量身定制DST干预措施以解决健康的方法 历史上边缘化的人群的担忧。 Lohr博士和她的心理团队创造了一个全面的 培训计划将以她以前的经验为基础，并在新领域扩大她的知识和技能。博士 LOHR的培训目标是：1）提高特定混合方法技能和量身定制的理论的应用 健康公平研究； 2）加速DST的内容专业知识； 3）加深卫生公平专业知识 从机械基础的原则到将与糖尿病相关的健康差异研究转化为政策 和临床实践。为了实现这些目标，Lohr博士提出了一项混合方法研究，以识别和 说明哪些社会人口统计学因素和基线T2D指标影响拉丁裔人如何反应 DST干预。这项工作以变化的故事为基础（S4C）（5R01DK113999-03），这是一个协作的 Latinx社区合作伙伴与罗切斯特健康社区伙伴关系之间的研究工作。成功的 这项研究的完成将导致第一个创作的出版物，并产生关键的初步数据 需要支持竞争性K奖励申请。总体而言，这种集中的培训，研究经验， 社区和学术合作的建立将支持Lohr博士的职业和专业人士 进步并允许她建立一个基础，她可以从中从事成功的职业 独立资助的科学家专注于旨在减少糖尿病分布的研究。