SmartStart: A digitally-enhanced diabetes self-management intervention for low-income people newly diagnosed with type 2 diabetes - PROJECT SUMMARY/ABSTRACT Type 2 diabetes (T2D) is an important public health challenge associated with significant morbidity, mortality, and increased healthcare costs. Low-income populations are 2.5 times more likely to have T2D and experience a disproportionate burden of poor health outcomes. Diabetes Self-Management Education and Support (DSMES) is an evidence-based program recommended for every person newly diagnosed with T2D with proven efficacy for improving health behaviors and outcomes. However, <5% of low-income individuals with T2D engage in DSMES within the first year of diagnosis, further exacerbating disparities. Multilevel and multidimensional barriers contribute to DSMES underutilization in this high-risk population, and these must be considered in order to promote health equity. Digital health interventions show promise for increasing access, uptake, and relevance of health promotion interventions among underserved communities where the ubiquitous nature of cell phones can also be leveraged to enhance engagement. To our knowledge, there are no digital health interventions tailored to low-income people newly diagnosed with T2D in the US. The first year of diagnosis is a critical window for establishing and sustaining self-management behaviors that promote health across the lifespan. This K99/R00 proposal is guided by the National Institute on Minority Health and Health Disparities Research Framework to support research, mentorship, training, and community-engagement activities that will foster the growth and trajectory of an early-stage health equity scholar focused on improving T2D-related health among low-income populations. The K99 research goal is to co-create a user-informed, digitally enhanced DSMES tailored to the education and support needs of low-income adults newly diagnosed with T2D. The R00 research goal is to establish the feasibility, acceptability, and preliminary effects of the intervention in a Federally Qualified Community Health Center on engagement in DSMES, changes in self-management behaviors, and improvements in health outcomes (A1c, weight, and quality of life). The proposed research sets the stage for a full-scale R01 that will test the efficacy of the digitally enhanced DSMES intervention to improve health outcomes among low-income patients newly diagnosed with T2D. The PI has established a transdisciplinary mentorship team of NIH-funded health disparity scholars and a comprehensive training plan guided by an individual development plan to expand her skills, knowledge, and professional network to support a career focused on advancing health equity through accessible, sustainable, and scalable system-level interventions for underserved populations. The applicant’s long-term goal is to become an independent, NIH-funded scientist with a research program focused on developing and implementing community-informed, culturally- and contextually relevant interventions that improve diabetes-related health outcomes among underserved populations.
