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TELE Para DM: Telemedicine Equity for Limited English Proficient Patients with Diabetes Mellitus in the Safety Net

Award Number: K23MD016943
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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TELE Para DM: Telemedicine Equity for Limited English Proficient Patients with Diabetes Mellitus in the Safety Net - Project Summary/Abstract Telemedicine (remote telephone and video health visits) is a digital health tool that can increase access to care and improve health outcomes. Telemedicine care has been critical to maintaining healthcare access when in- person care is disrupted, and the arrival of the Coronavirus-19 disease (COVID-19) pandemic forced the integration of telemedicine into care almost overnight. But this is problematic for safety net health systems who disproportionately provide care to racial/ethnic minority and Limited English Proficient (LEP) patients, who have faced significant barriers with past digital health technology. In this K23, we will study telemedicine in the Los Angeles County Department of Health Services (LAC DHS)— the second largest safety net in the United States. We will focus on a particularly vulnerable population with need for frequent, interval care: patients with diabetes mellitus (DM), specifically addressing LEP Spanish-speakers, who are 62% of the DM patients at LAC DHS. This K23 proposal will investigate differences in factors affecting telemedicine use and explore associated quality of diabetic care via quantitative and qualitative analyses among Spanish- and English- speaking primary care patients (Aim 1). In partnership with the LAC DHS Virtual Care Workgroup, these analyses will inform the tailored design of a patient coaching intervention in Spanish and in English to increase and facilitate telemedicine use (Aim 2) and a pilot randomized controlled trial of the bilingual intervention (Aim 3). These aims will be achieved using mixed methods, implementation science, and digital health disparities conceptual frameworks as they address the NIMHD research priority areas of developing interventions to improve access to care for vulnerable patients and reduce health disparities. The studies are novel given the timely focus on telemedicine implementation for vulnerable patient populations, addressing LEP patients explicitly, as well as the proposed use of mixed methods to develop a theory-driven intervention. The proposed studies are informed by Dr. Alejandra Casillas’ role as a primary care physician and her patient portal research experience in diverse, urban primary care settings. Dr. Casillas’ long-term goal is to develop interventions that reduce digital health disparities, increase health access, and improve health outcomes for racial/ethnic minority and LEP patients. During the course of this award, Dr. Casillas will undertake didactic and experiential training to improve knowledge and skills in three areas: (1) mixed methods in digital health disparities research, (2) telemedicine delivery in the safety net, and (3) evaluation of pilot trial interventions in real-world clinical settings using implementation science methods. Dr. Casillas has assembled a multi-institutional mentorship team with the complementary expertise to ensure completion of the proposed research and training and successful transition to independence. This K23 will position Dr. Casillas, as an early career investigator, to develop a NIMHD-R01 for other languages and chronic disease conditions: findings could result in widespread adoption of this model as an evidence-based intervention to augment telemedicine for vulnerable patients in the US.


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: 2024 ( Subtotal = -$210,188 )
2024	2023	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	002	2	1/10/2024	NON-COMPETING CONTINUATION	-$1
2024	2023	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	000	2	10/23/2023	NON-COMPETING CONTINUATION	-$175,391
2024	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	001	1	1/10/2024	NEW	-$34,796
2024	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	003	1	4/8/2024	NEW	$0
														Subtotal = -$210,188

Issue Date FY: 2023 ( Subtotal = $175,392 )
2023	2023	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	001	2	1/27/2023	NON-COMPETING CONTINUATION	$17,539
2023	2023	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	000	2	12/12/2022	NON-COMPETING CONTINUATION	$157,853
														Subtotal = $175,392

Issue Date FY: 2022 ( Subtotal = $175,392 )
2022	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Minority Health and Health Disparities Research	000	1	3/30/2022	NEW	$175,392
														Subtotal = $175,392

Grand Total All Awards = $140,596

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TELE Para DM: Telemedicine Equity for Limited English Proficient Patients with Diabetes Mellitus in the Safety Net

Award Number: K23MD016943

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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