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Latinos Understanding the Need for Adherence in Diabetes using Care Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E)

Award Number: R01MD015080
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Latinos Understanding the Need for Adherence in Diabetes using Care Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E) - Project Summary/Abstract The proposed Latinos Understanding the Need for Adherence in Diabetes using Care Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E) randomized controlled trial will test the effectiveness of an innovative patient-centered, team-based, primary care intervention in improving diabetes outcomes in Latino patients of San Ysidro Health (SYH), a large federally qualified health center (FQHC). The proposal builds on more than 17 years of research by our academic (San Diego State University; SDSU) community (SYH) partnership. LUNA-E will recruit and randomize N=400 Latino adults with poorly controlled diabetes into usual care plus (UCP) or special intervention (SI). UCP represents methods recently initiated by the SYH Patient Centered Medical Home initiative, in which a medical assistant provides care coordination, referrals, and brief health education in collaboration with the primary care provider. The LUNA-E SI is a highly integrated, culturally specific for diabetes, team-based approach informed by the Chronic Care Model of healthcare and Resources and Supports for Self- Management Model of behavior change. The SI includes: 1) Care Coordination by a specially trained health navigator; 2) Visits with a Behavioral Health Provider with knowledge of diabetes, local culture, the integrated model, and psychosocial aspects of diabetes care; 3) Care integration among the Primary Care Provider, Behavioral Health Provider and Care Coordinator via a clinical decision support “dashboard” in the patient electronic health record (EHR); 4) Evidence-based, culturally adapted diabetes self-management education delivered via patient portal. The study will test hypotheses that the LUNA-E SI will lead to larger improvements in glycemic control (HbA1c levels; Aim 1) and psychological distress (depression and anxiety symptoms; Aim 2) at 6-months post randomization when compared to UCP, and the degree to which these differences are explained by conceptually driven mediators (improved resources and supports for self- management, patient activation, medication adherence and self-management behaviors; Aim 3) A matched retrospective True Usual Care (TUC) group (N=200) will be extracted from EHR using propensity score matching, to evaluate diabetes outcomes in UCP and SI versus patients with little to no care coordination and health education and no study visits. A thorough process evaluation will assess intervention reach, effectiveness, adoption, implementation, and maintenance (RE-AIM). LUNA-E has excellent potential for high impact and broad dissemination due to its community partnered approach, reliance on EHR and E-Health, and implementation within a large, exemplar FQHC primary care environment.


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: 2025 ( Subtotal = $605,808 )
2025	2025	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	001	5	4/4/2025	NON-COMPETING CONTINUATION	$605,808
2025	2024	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	000	4	3/6/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $605,808

Issue Date FY: 2024 ( Subtotal = $593,162 )
2024	2024	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	001	4	6/8/2024	NON-COMPETING CONTINUATION	$593,162
2024	2023	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	000	3	3/13/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $593,162

Issue Date FY: 2023 ( Subtotal = $611,529 )
2023	2023	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR MC1947	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	000	3	2/24/2023	NON-COMPETING CONTINUATION	$611,529
														Subtotal = $611,529

Issue Date FY: 2022 ( Subtotal = $608,788 )
2022	2022	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR MC1947	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	001	2	4/29/2022	NON-COMPETING CONTINUATION	$60,879
2022	2022	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR MC1947	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	000	2	2/7/2022	NON-COMPETING CONTINUATION	$547,909
														Subtotal = $608,788

Issue Date FY: 2021 ( Subtotal = $621,867 )
2021	2021	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR MC1947	SAN DIEGO	CA	92182	SAN DIEGO	USA	Minority Health and Health Disparities Research	000	1	6/8/2021	NEW	$621,867
														Subtotal = $621,867

Grand Total All Awards = $3,041,154

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Latinos Understanding the Need for Adherence in Diabetes using Care Coordination, Integrated Medical and Behavioral Care and E-Health (LUNA-E)

Award Number: R01MD015080

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

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