Saturday, June 10, 2023
6/10/2023
Type 2 diabetes (T2D) disproportionately affects socioeconomically disadvantaged and racial/ethnic minority communities, including Hispanics/Latinos (hereafter Latinos), the largest ethnic/racial group in the U.S. While Austin/Travis County has trended better than Texas and the nation on key health outcomes, including T2D, over the past 5 years, we persistently see disparities along racial, ethnic, and socio-economic lines. Causes of Latino diabetes disparities are multi-faceted and include factors such as low health literacy, language barriers, cultural beliefs, attitudes, and beliefs towards T2D and treatments, lack of family support, and access to resources. Innovative, culturally appropriate models are needed to address T2D disparities in the large, growing US Latino population. To begin to address diabetes disparity in Austin, the Latino Research Institute at the University of Texas at Austin will partner with the YMCA of Austin (YMCA) to plan and implement Y Living with Diabetes (Y Living-D), an evidence-based, family-centered T2D self-management program. Y Living-D is a 12-week program grounded in Social Cognitive Theory and the Socioecological Model designed to engage the whole family in developing T2D self-management knowledge and self-efficacy with regard to physical activity, healthy eating, glucose monitoring, and stress reduction. Y Living-D helps families build skills in goal-setting, self-monitoring, and creating a supportive environment at home with the aim to improve glycemic control and health-related quality of life for people with T2D from minority, disadvantaged families in Austin, TX. Researchers will engage community stakeholders in formative research to adapt an existing Y Living program for T2D. Y Living-D will use innovative and modern digital technologies, e-Learning, and community health workers to address the unique social, cultural, and environmental factors facing individuals from minority populations with T2D and their families. We will conduct a 2-arm randomized controlled trial to compare effectiveness of Y Living-D on HbA1c and quality of life (primary outcomes) and diabetes self-management behaviors (DSM; secondary outcomes) for individuals from minority, disadvantaged families with T2D living in Austin, TX. We will recruit 226 individuals with physician-diagnosed T2D and one family member from two YMCAs in Austin. Dyads will be randomized to either Y Living-D (n=113) or usual care (n=113). In addition to outcome evaluation, we will conduct a rigorous process evaluation of Y Living-D using the RE-AIM framework, a mixed-methods approach, and measures developed in previous studies with a critical focus on important outcomes for the implementation, scaling, and diffusion and dissemination of programs in real-world settings. The goals of this proposed project are to: 1) plan a randomized controlled trial to evaluate the effectiveness of Y Living-D; 2) increase adoption of DSM behaviors (i.e., glycemic control, physical activity, healthy eating, mindfulness practice) among Y Living-D participants with T2D and their families; and 3) disseminate Y Living-D and increase organizational capacity of YMCA to implement Y Living-D and enhance program sustainability.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
