Research Profile

The DM Social Needs study was designed for African Americans aged 50 and older with poorly controlled type 2 diabetes (hemoglobin A1C >= 8%). This randomized controlled trial will use a problem-solving approach to resolve unmet social needs experienced by older African Americans with poorly controlled type 2 diabetes in addition to providing foundational diabetes self-management education and skills training. While there are a number of interventions that utilize navigation and referrals to social agencies for African Americans with type 2 diabetes, there are few studies for older, community dwelling African Americans with poorly controlled type 2 diabetes that helps the patient to resolve the self-identified and prioritized unmet social needs preventing them from successfully achieving health goals and improved outcomes. By resolving unmet social needs, older African Americans will experience less stress related to housing and food security, and be able to financially afford medications and supplies needed to manage diabetes. Reduced stress and worry about these basic needs will allow patients to focus on completing necessary health promoting and diabetes self-management activities.

Did you know that about 40% of adults aged 50 years and older have diabetes, and older adults with diabetes experience more complications compared to younger adults? Moreover, African Americans are 60% more likely to be diagnosed with diabetes, more likely to experience complications, and are twice as likely to die due to diabetes compared to Whites. African Americans with diabetes have a higher rate of complications due to high blood sugar levels, high blood pressure, and high cholesterol compared to Whites. Unfortunately, structural racism has resulted in fewer economic opportunities for African Americans, higher unmet basic needs resulting in lack of finances, housing, food and transportation. Therefore, to help improve your health and the health of other older African Americans with type 2 diabetes and unmet social needs, we must combine diabetes education and skills training with strategies to identify and resolve unmet social needs. The information learned from this project will help me understand whether an effective method of helping you and other African Americans with type 2 diabetes and unmet basic needs to lower your blood sugar, lower your blood pressure, and lower your cholesterol is by using a nurse case-manager, telephone-delivered intervention that provides diabetes self-management education and skills training and resolves the unmet social needs. The findings from this study will pave the way for optimization of care delivery among older African Americans with T2DM and social needs.

I am an African American woman and health services researcher who earned my PhD in Health and Rehabilitation Science from the Medical University of South Carolina in 2018. I completed postdoctoral training in health disparities from 2018-2019 and joined the faculty of the Medical College of Wisconsin in July 2019. Since then, I have focused my research career on understanding the impact of social determinants of health on older African American adults with type 2 diabetes. My long-term goal is to become an independent health services researcher focused on developing and testing interventions to improve clinical, behavioral, and quality of life outcomes for home dwelling, older African Americans with type 2 diabetes and unmet social needs. My training and experience working with vulnerable populations, and conducting health services research, offer a unique perspective and broad proficiency in health services research design, analytical techniques, program evaluation, and grant administration. In addition, as an African American woman with family members with type 2 diabetes, one of whom died shortly after completing my degree from diabetes-related complications, gives me unique insight that will be relevant to developing expertise in this area of research. I am passionate about social determinants of health and health disparities, particularly in patients with diabetes. With the proper experience available through this award, including the opportunity to design, run, and manage my own study under the guidance of my mentoring and co-investigator team, I will gain the education, skills, and competence necessary to become a highly successful independent diabetes investigator. In addition, this grant will afford me the opportunity to test the preliminary efficacy of the proposed intervention and use the information learned to develop a larger R01 proposal to be submitted by the end of the funding period and continue to inform the field on effective interventions for older African Americans with poorly controlled type 2 diabetes.

I see the future of diabetes focusing on addressing upstream factors associated with physical and mental health outcomes of older adults with poorly controlled type 2 diabetes. Specifically, more strategies that are designed to address structural inequities and structural racism such as policies around housing, transportation, economic opportunities, etc.