Behavioral Research Project
Converting a Traditional In-Person Diabetes Self-Management Education and Support (DSMES) Intervention into a Digital Version for More Accessible Diabetes Self-Management
Diabetes is among the top ten leading causes of death among adults 18 years of age and older. Hispanics are disproportionately represented, having greater than 50% chance of developing type 2 diabetes mellitus (T2DM) at an earlier age, higher rates of diabetes-related kidney failure, and higher rates of diabetes-related vision loss than non-Hispanic whites. The cost associated with diabetes in the United States, in 2022, was reported to be over $412.9 billion dollars with $306.6 billion related to direct cost of the disease (e.g., insulin and diabetic supplies) and over $160.3 billion associated with indirect cost (e.g., lost work and wages). An effective way of reducing the risk of diabetes complications, hospitalization, and mortality, is through Diabetes Self- Management Education and Support (DSMES) interventions; however, these programs are extremely underutilized and not convenient or accessible to most patients with T2DM. The On the Road to Living Well with Diabetes (OTR) DSMES program was developed to increase self-management of diabetes. The OTR-DSMES program is currently offered in-person and is led by community health workers (CHWs). The proposed project will adapt the in-person bilingual OTR-DSMES intervention into an online digital health version of the OTR DSMES. We propose three specific aims. The proposed project will adapt the in-person bilingual OTR-DSMES intervention into a web-based digital health version of the OTR DSMES to improve the Standards of Care for people living with T2DM. The proposed study will test the web-based OTR DHI against the in-person delivered OTR DSMES in a 12-week longitudinal RCT.
Investigative Team
The synergy of these early-stage investigators and their unique skills is essential for completing the proposed studies. Dr. Gabriel Frietze, is a tenure-track Assistant Professor in the School of Pharmacy. He is a research health psychologist and behavioral scientist with experience in experimental methodology, behavioral interventions, and quantitative statistics. He will afford the project expertise in the development, assessment, and interpretation of the RCT data. Additionally, his experience developing and implementing bilingual DHIs will contribute critically to the development of the proposed intervention. Dr. Bibiana Mancera is a UTEP NIH FIRST tenure-track Assistant Professor and the Core Lead of the UTEP Border Biomedical Research Center (BBRC) Community Engagement Core (CEC). She contributes expertise in recruiting study participants from the community, and training and working with CHWs. She is a qualitative expert and has experience working with Hispanic populations to assess risk and protective factors as well as obstacles and facilitators to health. Her work with the CHW led OTR-DSMES as well as her collaboration on the development of a bilingual DHI are essential to completing the proposed project. Drs. Frietze and Mancera are currently collaborating on several research projects including the Paso del Norte Health Foundation funded OTR-DSMES intervention). Dr. Margie Padilla, PharmD, CDCES, BCACP, a Clinical Professor and Chair for the Department of Pharmacy Practice and one of a hand full of Certified Diabetes Care and Education Specialist in the region, will guide the adaptation of the online DSMES modules and additional DSMES topics including insulin delivery systems and foot care for people with diabetes to improve the quality of the DSMES intervention. Dr. Maria O. Duarte-Gardea, PhD, RD, LD, is a professor and chair of the Department of Public Health Sciences. She is an expert in nutrition, chronic disease prevention, and community based participatory research. As a senior investigator with experience in the development and implementation of interventions, she will provide guidance and oversight of the transition of the OTR into a DHI. Dr. Surendranath S. Shastri, MBBS, MD, DPh is a professor in the Department of Health Disparities Research, at The University of Texas MD Anderson Cancer Center, Houston, TX. Dr. Shastri will serve as a consultant on the project to provide guidance and expertise for deploying a randomized controlled trial randomized (RCT). Please see Figure 1. above. Lastly, our team has extensive experience collaborating with Federally Qualified Health Centers (FQHCs) and local clinics throughout the region (see letters of support). Collectively, the synergistic and diverse expertise of Drs. Frietze, Mancera, Padilla, Duarte-Gardea, and Shastri, coupled with their experience in developing bilingual health related dissemination materials (e.g., intervention videos) for use among Hispanics, and the analytical capabilities of the UTEP BBRC, provides a unique nexus for successfully completing the proposed studies and contributing to this timely and needed research.
