The overall goal of seeking a K Award is to acquire the necessary training, practical experience, and knowledge to be a leading independent investigator in implementing interventions through web- and mobile-based technologies that address health disparities associated with diabetes and related diseases. Key objectives of the career development plan are to 1) gain experience with diabetes self-management; 2) gain experience with web-based technology and chronic disease; and 3) gain hands-on experience with the implementation and dissemination of interventions. The following is a description of the proposed research project: Uncontrolled diabetes can lead to macrovascular and microvascular health complications. African Americans have a greater burden of disease, worse health outcomes from diabetes and lower adherence to diabetes self-management goals. Novel approaches to delivering problem-solving skills training that improve diabetes self-management and CVD knowledge are needed. Decision-Making Education for Choices in Diabetes Every Day (DECIDE) (Hill-Briggs) is a problem-solving curriculum that is successful in improving adherence to self-management behaviors in African Americans. However, one limitation of DECIDE is the face to face application. Previous interventions which focus only on problem-solving do not involve the use of web-based technology. The proposed study will explore the translation of DECIDE into an effective web-based program (eDECIDE) for African American patients with uncontrolled diabetes. We hypothesize that eDECIDE can effectively be delivered. We will explore this through three AIMS: 1) To translate and design the DECIDE curriculum into a user-centered web-based program, eDECIDE; 2) To assess patient usability and satisfaction with eDECIDE design; 3) To test eDECIDE in a pilot 9-week randomized controlled trial (n=70), measuring change in HbA1c (primary outcome) and the following secondary outcomes: blood pressure, cholesterol, problem-solving skills, Diabetes and CVD Knowledge, Nutrition, and Diabetes Self-Care behaviors. To investigate our aims we will conduct a task analysis of the DECIDE curriculum, (wireframe architecture) followed by usability testing (website evaluation) and finally conduct a pilot, 9-week randomized controlled trial of eDECIDE. Relevance: Findings from the proposed application have potential to shed light on ways to improve HbA1c and enhance delivery of problem-solving skills training to improve diabetes self-management behaviors among African American populations.
Diabetes mellitus is a major public health concern and it disproportionally affects African Americans. Uncontrolled diabetes requires some level of behavior change to increase adherence to diabetes self-management behaviors and lessen the impact of poor health outcomes associated with the disease. Problem-solving skills' training is beneficial in maintaining certain diabetes self-management behaviors.
