PROJECT SUMMARY/ABSTRACT
Rural areas, where ~60 million Americans live, have a higher burden of type 2 diabetes mellitus (T2DM)
compared to urban areas, yet, there is sparse information on T2DM risk factors and interventions that
improve T2DM primary prevention. Dr. Dugani, an academic hospitalist and early-stage investigator, is
committed to improving the primary prevention of T2DM in rural areas. His long-term goal as an
independent clinical investigator is to reduce health disparities for T2DM in rural populations by developing
patient-centered interventions for better T2DM primary prevention. The short-term goals of this proposal
are to acquire proficiency in data science, qualitative/mixed methods, health disparities research, and
clinical trial study design through a Master of Public Health degree; mentorship; and, leadership skills to
build and lead an independent research program to advance T2DM care. This research will be conducted
at Mayo Clinic, which has robust infrastructure and facilities for patient-oriented research. Dr. Dugani will
leverage data from the Centers for Disease Control and Prevention (Aim 1) and Mayo Clinic Biobank (Aims
2 and 3) to advance the research aims and also rely on a dedicated team of mentors and advisors with
expertise in T2DM, epidemiology, health disparities research, and health services research.
Dr. Dugani will accomplish his short-term goals through the novel Rural Patient Risks and Exposures for
Diabetes ConTrol (Rural PREDICT) study, which he developed to investigate the higher burden of T2DM in
Midwest rural compared to urban populations. At present, there is sparse information on risk factors for
T2DM in Midwest rural populations and no T2DM risk prediction score for Midwest rural populations.
Through Rural PREDICT, Dr. Dugani will address these knowledge gaps. Specifically, in Aim 1, he will
characterize the incidence rate and temporal trend of diabetes in the rural Midwest. In Aim 2, he will
evaluate the associations of traditional risk factors (e.g., lifestyle, socioeconomic status) and novel rural-
enriched risk factors (e.g., organic chemicals, pesticides) with incident T2DM in the rural Midwest. He will
directly engage rural patients to explore their perspectives regarding the high burden of risk factors. In Aim
3, he will develop a non-invasive (i.e., non-laboratory) 5-year T2DM risk prediction score for rural
populations and obviate the need for laboratory testing, which may be a barrier for rural populations. He will
engage patients to develop a meaningful, non-stigmatizing questionnaire for the risk score and explore
barriers to the use of this risk score. These studies will form the basis for an NIH R01 (years 4-5)
application to advance T2DM primary prevention in Midwest rural populations. His research goals align with
NIMHD's priority to reduce health disparities in minority groups, including rural communities.