Research Description
People of Hispanic or Latino/Latinx (“Latinx”) ethnicity, including US military servicemembers, Veterans, and their families, experience a higher prevalence of type 2 diabetes and more challenges managing diabetes than non-Hispanic whites. Uncontrolled diabetes is linked with lower quality of life, diabetes-related emotional distress, and severe medical problems. There are many reasons for this difference, including lack of culturally appropriate and bilingual Spanish healthcare services. Additionally, military patients may have fear or stigma about behavioral health care, an important part of treatment for many people with diabetes. Therefore, this study aims to improve healthcare and health outcomes for military Latinx patients by testing a values-based behavior change program, delivered using telehealth by bilingual health coaches. The six-week Acceptance Based Coping (ABaCo) skills program was developed by the study team with civilian community members. This study will test the helpfulness of ABaCo delivered by Latinx health coaches to military Latinx patients in a small pilot (practice) study, then in a larger study comparing the physical and mental health of those who receive ABaCo to those who do not. This project will also identify successful steps for establishing the ABaCo program in military treatment facilities. The ultimate goal of this study is to establish a helpful, easy-to-access, widely available program for Latinx military patients with diabetes that improves quality of life and diabetes control and lowers distress about diabetes. This study will also identify best approaches to providing ABaCo in military treatment facilities, providing lessons learned to other large healthcare systems.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?The SALUD-M project aims to establish an easy-to-access and effective program to support Latinx (Hispanic) military patients in their type 2 diabetes (T2D) self-management. We will use our Acceptance Based Coping (ABaCo) skills for diabetes program: a brief, culturally-tailored educational telehealth intervention, delivered by bilingual paraprofessionals. ABaCo was created in partnership with community health workers (“promotores”) to help address health disparities in Latinx communities, which often do not receive culturally- or contextually-appropriate diabetes care. In our ADA-funded project, we are partnering with Latinx U.S. military patients, who have worse outcomes than non-Latinx White military patients, to (1) tailor ABaCo to this new setting and population, (2) test the effectiveness of ABaCo compared to usual care, and (3) understand how to best deliver ABaCo in a military treatment facility. Our goal is that ABaCo, delivered by bilingual Latinx health coaches, will lead to improved quality of life, glycemic control and coping skills, with reduced diabetes-related distress.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?Caring for T2D is complex and can be overwhelming, especially if you don’t have support that considers your values, culture, and lifestyle. Our SALUD-M project involves the ABaCo program, a brief, remotely delivered self-management support program that considers these things, and the individual as a whole person. Although the current project focuses on Latinx military patients, the lessons we learn will be applicable to other people with T2D. Our hope is to expand the ABaCo program in the future to others who may not have enough tailored support in their diabetes care journey.
Why important for you, personally, to become involved in diabetes research? What role will this award play?As a clinical health psychologist with expertise in integrated primary care, I have seen firsthand how devastating unmanaged T2D can be, and how challenging it is for patients to make lifestyle changes and adhere to treatment plans. Additionally, Latinx communities experience worse diabetes outcomes due to significant healthcare disparities, including a lack of culturally-appropriate interventions. As a clinician-scientist, I have been compelled to improve health equity in this area, and this award will directly support such efforts. Additionally, this award furthers my commitment to partnering with community members to develop innovative solutions that improve outcomes for ALL people affected by T2D.
In what direction do you see the future of diabetes research going?Despite astounding advances in biomedical and behavioral approaches to T2D, some communities are being left behind. Diabetes treatment strategies are only truly effective when they are accessible to, and accepted by, the communities that can benefit from them. Yet there are gaps in equal benefits from diabetes prevention and treatment innovations. Therefore, future diabetes research must increase focus – from the beginning – on designing and implementing interventions that consider the cultural and psychosocial context of where they are needed the most.