Research Database
Integrating cultural aspects into diabetes education (INCLUDE)
Lu Hu, PhD
Institution:
New York University School of Medicine
Grant Number:
7-22-ICTSN-08
Type of Grant:
Translational
Diabetes Type:
Pre-diabetes/insulin resistance
Project Date:
-
Project Status:
active

Research Description

Chinese immigrants suffer higher rates of diabetes and prediabetes than the general population. Diabetes can be prevented through lifestyle behavior change (weight loss, diet, and physical activity). However, many Chinese immigrants have no health insurance and speak little or no English, limiting their ability to access nutrition programs and medical services designed to prevent the disease. And because of high rates of poverty, fresh fruits and vegetables are either unaffordable or unavailable in the communities where they live. Our group will build upon our extensive work with New York City’s Chinese immigrant population. We will evaluate a diabetes prevention program that sends culturally tailored educational videos to Chinese immigrants with prediabetes using the WeChat app (a free text messaging app that is very popular in Chinese immigrants). The program will also provide access to a community supported agriculture program, in which participants receive fresh fruits and vegetables throughout the growing season. We believe this model can help address many barriers to diabetes prevention experienced by Chinese immigrants who are at risk of developing this disease. If found efficacious, it has great potential to be scaled up to other high-risk populations as we are using a free social media app to deliver these diabetes videos and the CSA program can be sustained with sliding scale payment models and the SNAP benefits that many low-income minority populations are eligible for. It can also serve as a program model for increasing food access to underserved communities by leveraging local farm and community partnerships.

Research Profile

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?

My project focuses on promoting health equity and increasing access to evidence-based diabetes interventions among underserved immigrants. Underserved immigrants bear a disproportionate burden of type 2 diabetes. Evidence that lifestyle behavior change reduces the incidence of the disease was published over 20 years ago. Despite this, immigrant populations continue to experience numerous barriers to accessing preventive care. My project will test an innovative model of care to circumvent social determinants of health-related barriers to accessing diabetes prevention counseling. We will evaluate a diabetes prevention program that sends culturally-tailored educational videos to low-income Chinese immigrants with prediabetes via a free social media application. We will also provide access to a community-supported agriculture program, in which participants receive fresh fruits and vegetables throughout the growing season.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

Underserved immigrants face numerous barriers to attending in-person diabetes prevention programs including lack of transportation, limited health insurance/ability to pay, and lack of sick time from work. Additionally, existing programs usually are not tailored to the culture of immigrants, are not offered in the language that they speak, and counsel them to consume foods that may not be affordable or available in the communities where they live. Our project addresses each of these limitations. We bring culturally tailored diabetes prevention counseling to underserved immigrants that is offered in the language that they speak. Participants access the program from their mobile phone, using a free social media platform, at a time and place that is convenient for them. To assure access to healthy food, the program is paired with a nearby community-supported agriculture program.

Why important for you, personally, to become involved in diabetes research? What role will this award play?

Racial and ethnic minorities suffer a high diabetes burden and face numerous barriers to evidence-based diabetes programs. Despite significant medical advancements, diabetes disparities worsened over the past few decades. I am really passionate about promoting health equity and improving diabetes outcomes in underserved racial and ethnic minorities. This award will provide me with an unparalleled opportunity to test an innovative model of care and examine a multi-level intervention to address social determinants of health barriers and prevent diabetes in an underserved immigrant population. As an early-stage investigator, this award will help me to build an independent program of research focusing on minority health and diabetes disparities research in underserved communities.

In what direction do you see the future of diabetes research going?

I think the future of diabetes research will focus on three main themes: precision medicine, new therapeutics and technologies, and health equity. We will continue to see exciting breakthroughs in diagnostics, prevention, and treatment. There will be new therapeutics and medicines to treat or prevent diabetes and new technologies to monitor and manage the disease. In addition, precision medicine will help us determine the best treatment option based on each individual’s genetic, biological, physiological, and psychosocial characteristics. Last but not the least, health equity research will help us understand gaps in diabetes care and health outcomes, identify potential contributors, and develop and test strategies to reduce the gaps and promote health equity among underserved populations and communities.