Latino adolescents with Type 1 Diabetes (T1D) face substantial disparities in care and outcomes, making new tools to support this population essential. Managing T1D requires a complex set of knowledge and decision- making skills. Adolescents have specific challenges to managing T1D, including psychosocial needs for autonomy and fitting in with peers, along with still-developing decision-making and planning skills. Additionally, Latino adolescents face both unique challenges and a lack of access to culturally-sensitive care and support that recognizes the unique experiences, language, and barriers for these patients. Previous research in social psychology has demonstrated that counterfactual ("what if") thinking paired with appropriate educational content can improve health outcomes. Convergently, innovative culturally sensitive approaches to diabetes care and patient education improve T1D outcomes for Latino adolescents. Although numerous mobile applications (apps) exist for diabetes management, none currently offer a feature set targeted to this population that combines cutting-edge behavioral science on self-efficacy and behavior change with models of culturally appropriate care. Our preliminary studies demonstrate the impact of counterfactual reflection tasks on healthy eating intentions in Latinos, the effects of culture on counterfactual functionality, and the benefits of culturally-sensitive care to outcomes in Latino adolescents with T1D, offering proof-of-concept for the core assumptions of this product. In this Phase 1 SBIR, we will build a prototype of a new app that will help Latino adolescents manage their T1D by offering strengths-based, culturally sensitive tools to build knowledge and facilitate self-efficacy and planning. We will achieve this through two aims. Aim 1 will optimize the design of the app through end user research and internal testing. Aim 2 validate the acceptability and usability of the app. To do this, we will develop new reflection tasks to facilitate self-management and validate these tasks through mixed-methods research in patient populations. Additionally, we will test the usability and acceptability of a working prototype in the end user population through semi-structured interviews and quantitative measurement. By creating an innovative app to manage T1D, the planned research will offer advancements to the treatment of T1D in Latino adolescents. Additionally, the research will provide insights into how social cognitive science can be integrated into clinical practice to support patient efficacy in managing T1D. Beyond improving clinical care, the research will advance social cognitive psychology by investigating the functionality of counterfactual reflection and intention generation in a novel health domain. Together, these innovations will address a critical disparity in health to advance healthy living for Latino Americans as well as offering new tools for future innovations to reduce disparities in related domains.
Public Health Relevance Statement: PROJECT NARRATIVE Hispanic and Latino teens face numerous challenges to the complex task of managing Type 1 Diabetes, and as a result have inequities in health outcomes. To address this disparity, the proposed research will leverage cutting- edge behavioral science principles from social cognitive psychology and best practices for culturally-attuned care to develop an innovative mobile application (app) that offers easy-to-use, culturally sensitive tools to help teens manage their diabetes through smart coaching that provides feedback, educational content, and self-refection prompts, as well as summary reports to aid family and care team communication. The tools developed in this research will offer new approaches to improve the health of Latino adolescents with Type 1 diabetes, and may also be useful in developing tools to help other groups (such as Latino adults) and medical conditions (such as Type 2 diabetes).
Project Terms: 21+ years old; Adult Human; adulthood; Adult; Affect; Behavioral Sciences; Clinical Trials; Communication; Decision Making; Diabetes Mellitus; diabetes; Insulin-Dependent Diabetes Mellitus; Brittle Diabetes Mellitus; IDDM; Juvenile-Onset Diabetes Mellitus; Ketosis-Prone Diabetes Mellitus; Sudden-Onset Diabetes Mellitus; T1 DM; T1 diabetes; T1D; T1DM; Type 1 Diabetes Mellitus; Type 1 diabetes; Type I Diabetes Mellitus; insulin dependent diabetes; insulin dependent type 1; juvenile diabetes; juvenile diabetes mellitus; ketosis prone diabetes; type I diabetes; type one diabetes; Non-Insulin-Dependent Diabetes Mellitus; Adult-Onset Diabetes Mellitus; Ketosis-Resistant Diabetes Mellitus; Maturity-Onset Diabetes Mellitus; NIDDM; Non-Insulin Dependent Diabetes; Noninsulin Dependent Diabetes; Noninsulin Dependent Diabetes Mellitus; Slow-Onset Diabetes Mellitus; Stable Diabetes Mellitus; T2 DM; T2D; T2DM; Type 2 Diabetes Mellitus; Type 2 diabetes; Type II Diabetes Mellitus; Type II diabetes; adult onset diabetes; ketosis resistant diabetes; maturity onset diabetes; type 2 DM; type II DM; type two diabetes; Diet Records; Dietary Records; Food Diaries; Education; Educational aspects; Equilibrium; balance; balance function; Face; faces; facial; Family; Feedback; Food; Foundations; Future; Patient Care; Patient Care Delivery; Glucose; D-Glucose; Dextrose; Health; Glycosylated hemoglobin A; Glycohemoglobin A; Hb A1; Hb A1a+b; Hb A1c; HbA1; HbA1c; Hemoglobin A(1); hemoglobin A1c; Interview; Language; Learning; Libraries; Medicaid; Motivation; Patient Education; Patient Instruction; Patient Training; Patients; Pilot Projects; pilot study; Social Psychology; Research; Target Populations; Testing; Thinking; thoughts; Generations; Hispanic; Latino; Managed Care; medical costs; Medical Care Costs; Research Methods; research and methods; Research Methodology; Self Management; Caring; Intention; improved; Chronic; Specified; Specific qualifier value; Phase; Medical; psychological; psychologic; Adolescent Youth; juvenile; juvenile human; Adolescent; randomized, clinical trials; Ensure; Evaluation; insight; Data Bases; data base; Databases; Groups at risk; People at risk; Persons at risk; Populations at Risk; Summary Reports; Measurement; tool; Cognitive Science; cognitive psychology; Knowledge; Life; diaries; Complex; psychosocial; behavior change; American; experience; success; Self Efficacy; Structure; skills; novel; peer; social; Emotional; Modeling; Intervention; Intervention Strategies; interventional strategy; disparity in health; health disparity; Address; Small Business Innovation Research Grant; SBIR; Small Business Innovation Research; Validation; validations; Teenagers; Teen; teen years; teenage; Development; developmental; designing; design; new approaches; novel approaches; novel strategy; novel strategies; diabetic management; diabetes management; glycemic control; Outcome; Population; innovate; innovative; innovation; usability; prototype; commercialization; clinical care; patient population; clinical practice; Health Inequity; Inequalities in Health; Inequities in Health; health inequalities; mobile app; mobile device application; mobile application; Decrease disparity; Lower disparity; mitigate disparity; reduce disparity; reduction in disparity; disparity reduction; disparity in care; disparity in healthcare; health care inequality; health care inequity; healthcare disparity; healthcare inequality; healthcare inequity; health care disparity; Healthy Eating; care providers; patient barriers; patient-level barriers; Latino Population; Latino group; Latino individual; Latino people; Latinos; Knowledge Management; Disparity; Disparities
