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Dulce Digital-COVID Aware (DD-CA) discharge texting platform for US/Mexico border Hispanics with diabetes + COVID-19

Award Number: R01DK112322
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary Hispanics, a group that shows higher type 2 diabetes (T2D) prevalence, and poor self-management and clinical outcomes, have been disproportionally adversely impacted by COVID-19. The California Department of Public Health reports that Hispanics make up 39% of California’s population but an unprecedented 57% of the confirmed COVID-19 cases. This devastating finding is especially notable on the US/Mexico border. Diabetes has emerged as a leading risk factor for severe COVID-19 illness leading to hospitalization, is associated with greater disease severity and mortality and is an independent predictor of intensive care placement and invasive ventilation. It is becoming increasingly clear that maintaining good glucose control improves prognosis of COVID-19 among people with pre-existing T2D. However, social distancing, quarantine, and stay-at- home/lockdown guidelines may impact one’s ability to maintain adequate glycemic control. Research is needed to evaluate the effect and clinical outcomes of a flexible, easily adopted low cost digital intervention that improves glucose excursions and provides urgently needed COVID-19 mitigation strategies, among rapidly rising groups of high-risk Hispanics with poorly controlled T2D in US/Mexico border communities. Strong evidence from our parent grant Dulce Digital-Me, supports the use of technology (such as text messaging) alone or in combination with coaching interventions as a viable and desired method of delivering tailored diabetes self-management education and COVID awareness messaging to high-risk, underserved populations in a manner that is more convenient for both patients and staff while having the added benefit of being cost-effective for health systems, especially within low resource settings. However, effective interventions may encounter barriers which preclude guaranteed success upon implementation in the real world. This project, taking place along the San Diego/Tijuana border, historically the busiest land port of entry in the Western Hemisphere, will assess the effect of providing an enhanced digital texting intervention-Dulce Digital-COVID Aware (DD-CA) to N = 172 Hispanic patients with T2D upon discharge from a recent hospitalization. Key outcomes will assess the impact of DD-CA on hospital readmissions at 30 and 90 days post-discharge, glucose control and patient reported outcomes at 90 days post-discharge while also assessing COVID status and the implementation process. Given that DD-CA offers the potential to address many of the practical barriers to access and extend the reach of diabetes services, while additionally providing COVID awareness support, it offers an ideal low-cost and flexible solution to reduce hospital admissions and re- admissions in US/Mexico border communities significantly and simultaneously affected by COVID-19 and T2D. Implemented in a typical hospital and post-discharge setting, it augments existing care team processes, thus providing a valuable test of real-world effectiveness. More importantly, by helping to reduce existing inequities in access to diabetes and COVID-19 care, this program aims to improve health outcomes on a larger scale.


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: 2023 ( Subtotal = -$22,084 )
2023	2020	SCRIPPS HEALTH	4275 CAMPUS POINT CT	SAN DIEGO	CA	92121	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	6/7/2023	NON-COMPETING CONTINUATION	-$22,084
														Subtotal = -$22,084

Issue Date FY: 2021 ( Subtotal = $0 )
2021	2020	SCRIPPS HEALTH	10140 CAMPUS POINT DR, CPA 415	SAN DIEGO	CA	92121	SAN DIEGO	USA	Trans-NIH Research Support	000	5	7/16/2021	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2020 ( Subtotal = $869,415 )
2020	2020	SCRIPPS HEALTH	10140 CAMPUS POINT DR, CPA 415	SAN DIEGO	CA	92121	SAN DIEGO	USA	Trans-NIH Research Support	001	5	9/10/2020	SUPPLEMENT FOR EXPANSION	$306,364
2020	2020	SCRIPPS HEALTH	10140 CAMPUS POINT DR, CPA 415	SAN DIEGO	CA	92121	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	8/25/2020	NON-COMPETING CONTINUATION	$563,051
														Subtotal = $869,415

Issue Date FY: 2019 ( Subtotal = $559,059 )
2019	2019	SCRIPPS HEALTH	4275 CAMPUS POINT COURT CP215	SAN DIEGO	CA	92121	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	9/3/2019	NON-COMPETING CONTINUATION	$559,059
														Subtotal = $559,059

Issue Date FY: 2018 ( Subtotal = $572,339 )
2018	2018	SCRIPPS HEALTH	4275 CAMPUS POINT COURT CP215	SAN DIEGO	CA	92121	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	8/30/2018	NON-COMPETING CONTINUATION	$572,339
														Subtotal = $572,339

Issue Date FY: 2017 ( Subtotal = $586,473 )
2017	2017	SCRIPPS HEALTH	4275 CAMPUS POINT COURT CP215	SAN DIEGO	CA	92121	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	8/22/2017	NON-COMPETING CONTINUATION	$586,473
														Subtotal = $586,473

Issue Date FY: 2016 ( Subtotal = $611,361 )
2016	2016	Scripps Health	4275 Campus Point Court	SAN DIEGO	CA	92121	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	9/16/2016	NEW	$611,361
														Subtotal = $611,361

Grand Total All Awards = $3,176,563

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Dulce Digital-COVID Aware (DD-CA) discharge texting platform for US/Mexico border Hispanics with diabetes + COVID-19

Award Number: R01DK112322

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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