Saturday, November 23, 2024 11/23/2024

Dulce Digital-Me: An Adaptive mHealth Intervention for Underserved Hispanics with Diabetes

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

Group Awards By:

View Award Abstract

Project Summary. Individuals of low socioeconomic (SES) and ethnic minority status, including Hispanics, the largest U.S. ethnic minority group, are disproportionately affected by diabetes. Poor healthcare access and cultural barriers prevent optimal care, adherence, and clinical benefit, thus placing Hispanics at high risk for costly diabetes complications. Our established academic-healthcare-community partnership has unique experience in developing and testing innovative, cost-effective, and sustainable chronic care interventions to reduce disparities and improve health in underserved communities. We recently developed Dulce Digital (i.e., “one- size-fits-all” educational text messages, with nurse monitoring of patient-transmitted blood glucose values), which improved glycemic control across 6 months, relative to usual care in a recent randomized controlled trial (RCT) of N=126 Hispanic patients with poorly controlled type 2 diabetes (T2DM). Our process evaluation indicated that Dulce Digital was both feasible and acceptable from patient and provider perspectives; however, patients expressed a preference for a more individualized intervention, and providers requested an even greater focus on health behavior change. Thus, the proposed RCT will examine the comparative effectiveness of Dulce Digital versus “Dulce Digital-Me” (DD-Me) in N=414 Hispanic adults of low SES with poorly controlled T2DM from Neighborhood Healthcare, a San Diego Federally-Qualified Health Center. Guided by patient and provider feedback, DD-Me includes Dulce Digital components plus personalized goal-setting and feedback that is responsive to the individual’s needs and preferences. The DD-Me adaptive feedback component will be informed by the Resources and Support for Self-Management Model and Operant Conditioning Theory, and based on the individual’s progress on intermediate behavioral targets (i.e., medication adherence assessed by wireless sensor; brief mobile phone-based assessments of diet, physical activity, stress). Feedback will be delivered via algorithm-driven automated messaging in 50% of DD-Me participants and by the care team medical assistant in the remaining half to determine the feasibility and acceptability (given the purported cultural relevance of interpersonal relationships in the Hispanic culture), and the comparative effectiveness and cost of each delivery method. Changes in indicators of diabetes clinical control [i.e., glycosylated hemoglobin (HbA1c) low density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP)], patient-provider communication, and patient adherence (i.e., to medication and other diabetes self-management behaviors) will be evaluated across twelve months. Thorough process and cost-effectiveness analyses will evaluate the scalability and sustainability potential of DD-Me. Our comparative evaluation of two mHealth approaches will elucidate how technology can be integrated most effectively and efficiently within existing nurse-led chronic care approaches to meet the complex needs of underserved individuals with poorly controlled T2DM.


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

Top

All Categories

About

Search

Reports

Data Submission

Award Information

Dulce Digital-Me: An Adaptive mHealth Intervention for Underserved Hispanics with Diabetes

Award Number: R01DK112322

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer