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Expanding the Diabetes Homelessness Medication Support (D-Homes) program to Spanish speaking Hispanics

Award Number: R03DK133553
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/ABSTRACT Homeless people in the US face disproportionate risk for early death in part due to poorly controlled chronic diseases including diabetes. 1.5 million unique US adults access homeless shelters annually. People experiencing diabetes and homelessness develop complications 10 years earlier and die prematurely compared to their housed counterparts. This project works to achieve health equity for these people. Substantial evidence links medication adherence as a leading modifiable health behavior driving poor diabetes outcomes in low-income and homeless populations. Behavioral support for improved medication adherence among people experiencing diabetes and homelessness is the focus of our team’s ongoing work (K23DK118117). We’ve used qualitative data and community engaged approaches to develop a tailored behavioral intervention (the Diabetes Homeless Medication Support program [D-Homes]); pilot testing of this new intervention is ongoing. D-Homes offers 10 coaching sessions over 12 weeks targeting glycemic control via improved medication adherence. Coaching includes diabetes education and structured goal setting targeting medication adherence and psychological wellness. To date English fluency has been an enrollment criterion due to limited resources in the existing K23 award. Yet the Hispanic community has disproportionately higher rates of both homelessness and diabetes. This R-03 award will expand the D-Homes intervention to include Spanish speakers in two aims: (1) Adapt D-Homes protocols and translated treatment materials based on feedback from people with diabetes and homelessness who speak Spanish and are Hispanic (DH-SH). We will conduct 8-10 interviews to review materials, planned recruitment and retention strategies, and study logistics. (2) Assess feasibility and acceptability of the adapted D-Homes for DH-SH. We will recruit 12 DH-SH into a single-arm trial to assess acceptability and feasibility of (i) recruitment and retention; (ii) coaching content and treatment materials; (iii) outcome assessments. Data will include systematic tracking of recruitment and retention efforts, staff feedback, program satisfaction and post-treatment qualitative interviews. We hypothesize unique recruitment/retention needs and unique facilitators/barriers to medication adherence among DH-SH compared to English-speaking participants. Data will define solutions for use in future work. This study is significant because findings will enable a future, fully powered clinical trial of D-Homes that will enroll both English and Spanish speakers. Our team’s experience provides a robust foundation for this work: (1) Our bilingual/bicultural research staff supports our ongoing NIDDK-funded trial with Hispanic participants with type 2 diabetes (R01 DK113999); (2) The PI’s Mexican heritage, Spanish language skills, and leadership role at the local Health Care for the Homeless program; (3) Our team’s successful recruitment and retention of diverse participants in several behavioral trials with difficult-to-reach populations. This study is innovative as it will define necessary tailoring based on language and a key social risk factor to diabetes care, homelessness.


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 = $97,356 )
2023	2023	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	7/17/2023	NON-COMPETING CONTINUATION	$97,356
														Subtotal = $97,356

Issue Date FY: 2022 ( Subtotal = $97,176 )
2022	2022	HENNEPIN HEALTHCARE RESEARCH INSTITUTE	701 PARK AVE	MINNEAPOLIS	MN	55415	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	8/4/2022	NEW	$97,176
														Subtotal = $97,176

Grand Total All Awards = $194,532

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Expanding the Diabetes Homelessness Medication Support (D-Homes) program to Spanish speaking Hispanics

Award Number: R03DK133553

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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