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Improving medication adherence among people with diabetes who are homeless

Award Number: K23DK118117
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 03/28/2019
PERIOD OF PERFORMANCE END DATE: 12/31/2024

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Improving medication adherence among people with diabetes who are homeless - PROJECT SUMMARY The long-term objective of this project is to reduce the diabetes health disparities of people with type 2 Diabetes who experience Homelessness, herein abbreviated as DH. The study will focus on diabetes medication adherence as a modifiable behavior known to correlate with glycemic control, all-cause mortality, all-cause hospitalization, and health care cost. The aims are to: (1) Develop the initial Diabetes Homeless Medication Support (D-Homes) treatment manual through focus groups with DH (N=30) at various levels of glycemic control (HgA1c<7, 7-9, >9) and interviews with their multi-disciplinary providers (N=12), (2) Test patient perceptions of the feasibility and acceptability of study procedures and refine the D-Homes treatment manual through test cases (n=10), and (3) Conduct a pilot randomized control trial (N=54) to compare the effect of D-Homes (weekly phone/in-person sessions over 12 weeks) vs. enhanced standard care (identify/reinforce care team, printed educational materials) on medication adherence, glycemic control, and health care utilization. These aims follow a sequential exploratory mixed methods approach. Qualitative focus groups and interviews will gather data about the values, preferences, and barriers to medication adherence faced by DH and their response to proposed intervention components. The initial protocol will be developed using existing evidence-based models and interventions to improve medication adherence, specifically the Information Motivation Behavioral Skills and Collaborative Care Models and use of motivational interviewing as a counseling style. It will also include explicit support for housing, food access, and other psychosocial needs. We will further tailor our protocol by conducting ten test cases. A final protocol will be developed by integrating qualitative and quantitative findings from Aims 1 and 2 with input from a multi-stakeholder panel with providers and community members with lived experience of these issues and the mentorship team. This project will prepare Dr. Vickery for a career as an independent investigator focused on overcoming diabetes and other health disparities among historically disadvantaged groups. Her career development plan includes training goals to: (i) develop tailored, theory-based behavioral interventions to address the needs of vulnerable groups using mixed methods data, (ii) learn to conduct rigorous behavioral trials and statistical methods for analyzing results, (iii) learn to develop and use measures of patient-centered outcomes and medication adherence, (iv) advanced manuscript and grant-writing skills. The research will be conducted in an ideal environment, Hennepin County Medical Center, the largest safety net health care system in the region, and its research arm, the Minneapolis Medical Research Foundation. It will be further strengthened by Dr. Vickery’s appointment as an Assistant Professor at University of Minnesota, a large academic health center with a Clinical Translational Sciences Institute. The interviews and trial will be conducted at shelters in close collaboration with Hennepin County Health Care for the Homeless clinics where Dr. Vickery works clinically.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	4/14/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $324,748 )
2023	2023	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	5	8/24/2023	NON-COMPETING CONTINUATION	$0
2023	2023	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	5	8/24/2023	SUPPLEMENT FOR EXPANSION	$162,374
2023	2023	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	12/23/2022	NON-COMPETING CONTINUATION	$162,374
														Subtotal = $324,748

Issue Date FY: 2022 ( Subtotal = $162,670 )
2022	2022	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	12/23/2021	NON-COMPETING CONTINUATION	$162,670
														Subtotal = $162,670

Issue Date FY: 2021 ( Subtotal = $212,738 )
2021	2021	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	3	5/28/2021	SUPPLEMENT FOR EXPANSION	$0
2021	2021	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	1/15/2021	NON-COMPETING CONTINUATION	$162,670
2021	2021	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	3	1/26/2021	SUPPLEMENT FOR EXPANSION	$50,068
														Subtotal = $212,738

Issue Date FY: 2020 ( Subtotal = $217,826 )
2020	2020	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	8/19/2020	SUPPLEMENT FOR EXPANSION	$55,603
2020	2020	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	12/19/2019	NON-COMPETING CONTINUATION	$162,223
														Subtotal = $217,826

Issue Date FY: 2019 ( Subtotal = $163,890 )
2019	2019	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	3/28/2019	NEW	$163,890
														Subtotal = $163,890

Grand Total All Awards = $1,081,872

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Improving medication adherence among people with diabetes who are homeless

Award Number: K23DK118117

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 03/28/2019

PERIOD OF PERFORMANCE END DATE: 12/31/2024

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