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REACH-Es: Adapting a digital health tool to improve diabetes medication adherence among Latino adults

Award Number: K23DK135798
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 04/01/2023
PERIOD OF PERFORMANCE END DATE: 02/28/2027

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REACH-Es: Adapting a digital health tool to improve diabetes medication adherence among Latino adults - Background: Latino adults have a disproportionate burden of type 2 diabetes and diabetes-related complications. Diabetes medication non-adherence is an important modifiable contributor to suboptimal glycemic management among Latino adults, who are nearly twice as likely to report non-adherence to diabetes medications as non-Hispanic White individuals. Besides language barriers, additional commonly reported barriers that contribute to non-adherence in this population include negative perceptions about insulin use and misunderstanding ongoing need for diabetes medications once HbA1c has improved. Mobile health (mHealth) technology can reduce medication adherence barriers and improve adherence behavior, but mHealth tools that address commonly reported barriers to diabetes medication adherence among Latino adults are lacking. Candidate: I am an endocrinologist born and raised in Latin America; my long-term career goal is to develop scalable, patient-centered interventions that address gaps in diabetes self-care to improve outcomes among Latino adults with type 2 diabetes. Training: I have received outstanding research training in epidemiology but to achieve my long-term career goal I require additional training in: 1) adaptation of evidence-based interventions, 2) mixed methods, and 3) conduct of clinical trials in mHealth. Mentors: My training and research plans will be overseen by Primary Mentor Dr. Deborah Wexler (type 2 diabetes clinical trials/intervention adaptation) and Co-Mentor Dr. Lindsay Mayberry (mixed methodologist/mHealth clinical trials). Drs. Margarita Alegria (behavioral intervention adaptation to a Latino population), Enrique Caballero (cultural tailoring of diabetes interventions), J. Jaime Miranda (mHealth intervention development/testing), and Tanayott Thaweethai (biostatistics) will provide additional focused expertise. Research: I will adapt REACH, a text message-based mHealth platform with content tailored to address self-reported barriers to diabetes medication adherence (developed by Dr. Mayberry), to a Latino population (REACH-Español) with type 2 diabetes through two specific aims. Aim 1: Adapt and develop REACH-Es content on barriers to diabetes medication adherence with engagement of a group of stakeholders with diverse expertise and perspectives on diabetes self-care (n=8), qualitative input from Latino adults with type 2 diabetes (n=20-30), and beta testing for intervention refinement with stakeholder input. Aim 2: Conduct a pilot RCT (n=70) to assess feasibility, acceptability, and usability of REACH-Es, as well as intervention targets (diabetes medication adherence and barriers to adherence) comparing REACH-Es to control; secondary outcomes are HbA1c and diabetes self-efficacy. The project will generate preliminary data for an R01 hybrid-effectiveness implementation trial of REACH-Es. The completion of these training and scientific aims will facilitate my transition to becoming an independent physician-investigator focused on developing scalable, patient-centered interventions that address gaps in diabetes self-care to improve outcomes among Latino adults with type 2 diabetes.


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: 2026 ( Subtotal = $195,907 )
2026	2026	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	3/19/2026	NON-COMPETING CONTINUATION	$195,907
														Subtotal = $195,907

Issue Date FY: 2025 ( Subtotal = $196,170 )
2025	2025	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	2/21/2025	NON-COMPETING CONTINUATION	$196,170
														Subtotal = $196,170

Issue Date FY: 2024 ( Subtotal = $195,355 )
2024	2024	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	2/14/2024	NON-COMPETING CONTINUATION	$195,355
														Subtotal = $195,355

Issue Date FY: 2023 ( Subtotal = $196,547 )
2023	2023	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	3/17/2023	NEW	$196,547
														Subtotal = $196,547

Grand Total All Awards = $783,979

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REACH-Es: Adapting a digital health tool to improve diabetes medication adherence among Latino adults

Award Number: K23DK135798

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 04/01/2023

PERIOD OF PERFORMANCE END DATE: 02/28/2027

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