A Mobile Health Intervention to Reduce Diabetes Disparities in Chinese Americans
Condition: Type2 Diabetes
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      Chinese Americans are one of the fastest growing immigrant groups in the US, who suffer
      disproportionately high type 2 diabetes (T2D) burden and have poorly controlled T2D. Despite
      the well-documented T2D disparities in this minority group, limited work has been conducted
      to improve health outcomes in Chinese Americans. The goal of this Pathway to Independence
      Award (K99/R00) is to expedite the candidate's transition to an independent investigator who
      possesses focused expertise in development and evaluation of culturally and linguistically
      tailored and sustainable interventions to reduce T2D disparities in Chinese Americans. In the
      K99 phase of this award, the candidate will obtain critical training needed to accomplish
      this goal and will develop a short message service (SMS) intervention to improve T2D
      management in Chinese Americans.

      More specifically, the aims are to 1) characterize barriers and facilitators of glycemic
      control in Chinese Americans with T2D (Aim 1a); 2) develop culturally and linguistically
      tailored SMS intervention content (Aim 1b); and 3) assess the feasibility and acceptability
      of the SMS intervention in a pre-, post-test study (Aim 1c).

      In the R00 phase, the candidate will refine the SMS intervention based on the K99 pilot data
      and evaluate the proof-of-concept regarding its efficacy in a pilot randomized controlled
      trial among 66 Chinese Americans with T2D (Aim 2). Participants will be randomized to one of
      2 arms (n=30 each): 1) wait-list control and 2) SMS intervention. Both groups will continue
      to receive standard of care treatment for their T2D. The SMS group will receive brief
      lifestyle counseling videos via SMS links. At the end of the study, the wait-list control
      group will be provided the opportunity to receive the SMS-based counseling videos.
      Measurements will be obtained at baseline, 3, and 6 months. The primary outcome is HbA1c and
      secondary outcomes include self-efficacy, diabetes self-management behaviors, dietary intake
      and physical activity behaviors. Linear mixed modeling will be used to examine the group and
      group by time interaction effects between the SMS intervention and wait-list control group.
      Findings from this R00 study will inform a larger full-scale R01 efficacy trial of the SMS
      intervention, and ultimately, establish the candidate's program of research focused on
      developing and testing sustainable interventions to reduce disparities in chronic disease
      outcomes in Chinese Americans. This project can serve as a program model for other chronic
      disease interventions in Chinese Americans that require lifestyle modification (e.g.,
      prediabetes, hypertension), or for disparities research in other high-risk immigrant
      populations (e.g., South Asians, Hispanic Americans).
    


Intervention name(s): Standard of Care; SMS Intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): At the end of the study the control group will be provided with the opportunity to receive counseling videos delivered via SMS; Participants in the intervention group will receive SMS based video counseling which include both educational and SCT=-based behavioral content. In addition, participants will receive biweekly phone calls from study community health workers to review the video content and clarify questions, set goals, and problem-solve barriers to achieving the goals.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Chinese Americans; SMS intervention