PROJECT SUMMARY / ABSTRACT
Healthy nutrition habits are key to managing type 2 diabetes (T2D). However, American Indian and Alaska
Natives (AI/ANs) often lack access to healthy food and disproportionately experience food insecurity. Food
insecurity, defined as lack of consistent access to enough food for an active, healthy life, negatively impacts
one’s ability to manage blood sugar and body weight. I am pursuing a K01 Mentored Research Scientist
Development Award to fill critical training gaps in the areas of quantitative data analysis of intervention studies
and effectiveness and pragmatic study design. In order to effectively bridge my prior training and research
experience to obtain my first R01, I have carefully developed a mentored training plan that strategically supports
my research aims for this K01 award. I am currently Co-Investigator on a study team that developed a culturally
responsive diabetes nutrition education curriculum for AI/AN adults with T2D, entitled “What Can I Eat? Healthy
Choices for AI/ANs with T2D” (WCIE). WCIE includes interactive, hands-on nutrition education learning activities,
including portion control, decreasing sugary beverages and saturated fat, and problem solving for barriers to
healthful eating. In January 2020 we launched a tribally-supported, 6-site, waitlist control design test of WCIE.
In June 2021, we will complete data collection with 150 AI/AN adults who have T2D. Data will include 3 timepoints
for immediate intervention and 5 for waitlist intervention participants over 6 months with surveys (nutrition
knowledge, behavior, self-efficacy) and clinical outcomes (BMI, blood pressure, and HbA1c). Though WCIE does
not include a specific food insecurity intervention, we included a household food insecurity measure at all data
collection timepoints. In Aim #1 of this proposed K01 I will examine the relationship between food insecurity and
clinical WCIE outcomes in the existing dataset through secondary analysis to utilize my new intervention
quantitative data analysis skills and advance understanding of the moderating effect of food insecurity on
diabetes nutrition education and T2D outcomes among AI/ANs. In Aim #2 I will design/pilot test WCIE with added
service to improve healthy food access and evaluate its feasibility/impact on T2D outcomes at an urban AI/AN-
serving clinic in Oklahoma City, OK. We will work with the Oklahoma City clinic to identify their need for a healthy
food access service in the following domains: transportation, availability of healthy food, or affordability of healthy
food. Aim #2 will provide me the opportunity to utilize my new training in effectiveness and pragmatic trials study
design and quantitative data analysis of intervention studies. My detailed training plan includes formal
coursework at the University of Colorado Anschutz Medical Campus, seminars, workshops/conferences on
AI/AN health research, and support from my mentors who are experts and leaders in the area of AI/AN diabetes
health, AI/AN health interventions, T2D and food insecurity interventions, and quantitative/study design
methodology. The proposed training plan and aims will provide me with a set of skills and expertise needed to
successfully obtain R01 funding and become a leader in diabetes health disparities intervention science.