Understanding & Overcoming Food Insecurity in Diabetes Patients

理解

基本信息

批准号：
9087461
负责人：
Seth A Berkowitz
金额：
$ 18.69万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-01 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9087461
关键词：
Address Adherence Affect American Body Weight decreased Carbohydrates Caring Clinical Clinical Research Communities Community Health Centers Complement Complications of Diabetes Mellitus Consumption Diabetes Mellitus Diet Dietary Fiber Digestive System Disorders Effectiveness Emergency department visit Environment Equipment Face Food Food Access Funding Glycosylated hemoglobin A Goals Health Healthcare Systems Healthy Eating Home environment Hospitalization Housing Hyperglycemia Institutes Intervention K-Series Research Career Programs Kidney Diseases Knowledge Life Style Mentors Mentorship Methods Non-Insulin-Dependent Diabetes Mellitus Nutritional Outcome Participant Patient Care Patients Pharmaceutical Preparations Play Primary Health Care Principal Investigator Qualifying Randomized Controlled Trials Reporting Research Research Personnel Research Training Resources Risk Factors Role S-nitro-N-acetylpenicillamine Senior Scientist Time Training Translating Work base care systems career development clinical effect community organizations cost delivered meals diabetes control diabetes management disorder control disparity reduction evidence base glycemic control good diet healthcare community improved indexing innovation lifestyle intervention named group nutrition patient oriented pragmatic trial programs public health relevance research to practice saturated fat socioeconomics therapy design treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Food insecurity, defined as difficulty affording an adequate diet owing to cost, affects over 20% of the 29 million Americans with diabetes. Food insecurity is an important socioeconomic barrier to effective diabetes care: it is associated with worse diabetes control and increased emergency department visits and hospitalization. By incentivizing consumption of calorie-dense foods high in simple carbohydrates and saturated fats, instead of more expensive fresh produce and whole grains, food insecurity may undermine healthy diets that are crucial for diabetes management. This project will help advance our knowledge of the relationship between food insecurity and diabetes by identifying how food insecurity affects current diabetes management and examining the clinical effects of using different strategies to overcome it. Fundamental questions regarding the mechanisms underlying potential interventions remain unanswered. To address these gaps in knowledge, the principal investigator (PI) proposes a career development program that blends rigorous methodologic training with an innovative research agenda. This plan has three scientific objectives: 1) To determine the impact of food insecurity on a lifestyle change intervention: the REAL HEALTH Diabetes trial (R18 DK102737 NCT02320253), a pragmatic adaptation of the Look AHEAD lifestyle intervention to community health centers, 2)To estimate the effect of nutrition assistance program use on diabetes control for patients in a primary care network, and 3) To conduct a pilot randomized controlled trial to assess the feasibility of home-delivered medically tailored meals for food insecure diabetes patients with hyperglycemia. This research program complements the National Institute of Diabetes and Digestive and Kidney Diseases' strategic focus on translating clinical research to practice by overcoming barriers faced by patients in real-world settings, reducing disparities in special populations, making care more patient-centered, and innovating within systems of care. The long-term goal of this career development award is to establish the PI as an independent researcher with expertise in understanding how socioeconomic barriers affect diabetes management and pragmatic interventions to overcome them. Career development activities include training in advanced analytic methods and intervention design through formal coursework as well as mentorship by an exceptionally qualified team of senior scientists. Successful completion of this career development proposal will fill important knowledge gaps, and help improve diabetes management and reduce diabetes complications in patients with food insecurity.

描述（由适用提供）：粮食不安全，由于成本而被定义为难以获得足够的饮食，影响了2900万美国糖尿病的美国人中的20％以上。粮食不安全是有效糖尿病护理的重要社会经济障碍：它与糖尿病控制较差，急诊就诊和住院治疗增加有关。通过增加对简单的碳水合物和饱和脂肪的热量食物的消耗，而不是更昂贵的新鲜农产品和全谷物，食物不安全感可能会破坏对糖尿病管理至关重要的健康饮食。该项目将通过确定粮食不安全如何影响当前的糖尿病管理并检查使用不同策略克服它的临床效应，从而帮助我们了解我们对粮食不安全与糖尿病之间关系的了解。有关潜在干预措施的基本机制的基本问题尚未得到解决。为了解决这些知识差距，首席研究员（PI）提出了一项职业发展计划，将严格的方法论培训与创新的研究议程融合在一起。该计划具有三个科学目标：1）确定粮食不安全性对生活方式改变干预的影响：实际健康糖尿病试验（R18 DK102737 NCT02320253），对务实的务实适应提前的务实适应了对社区健康中心的生命疗法，以估算营养疗法对疾病的影响，以估算疾病的影响，以估算疾病的影响，以估算疾病的影响，并估算疾病的影响，并估算疾病的影响。试验随机对照试验，以评估食品不安全糖尿病患有高血糖的饮食医学量身定制的餐食的可行性。该研究计划符合美国国家糖尿病与消化研究所和肾脏疾病研究所的战略重点，专注于将临床研究转化为实践，通过克服现实世界中患者面临的障碍，减少特殊人群的分布，从而使护理更具患者为中心，并在护理系统中引入。该职业发展奖的长期目标是将PI建立为独立研究人员，该研究人员具有专业知识，以了解社会经济障碍如何影响糖尿病管理和务实的干预措施以克服它们。职业发展活动包括通过正式课程进行高级分析方法和干预设计的培训，以及一支精湛的高级科学家团队的心态。成功完成这项职业发展建议将填补重要的知识差距，并有助于改善糖尿病管理并减少粮食不安全患者的糖尿病并发症。