The objective of this application is to develop collaborative management of type 2 diabetes in black Americans. In parallel, the PI's goal is to achieve investigative independence. The central hypothesis is that culturally sensitive collaboration is essential to improving diabetes outcomes in blacks. This hypothesis is based on the Symbolic Interaction Theory. The ISAS paradigm, a modification of this theory, explains Individual behavior as a response to Symbols (meanings) in relation to both an Audience (health care providers) and the Situation (systems and social support). Thus, diabetes self-management in blacks will depend on meanings attached to, and cultural relevance of the provider-patient interaction, and Systems/social support. The rationale for this research is that culturally sensitive collaboration is crucial to changing the poor outcomes of type 2 diabetes in black patients that impact their diabetes outcomes, to identify impediments to improved diabetes outcomes in Blacks that are attributable to health care providers, and to identify external factors that impact on diabetes outcome in Blacks. This research is innovative because it integrates modern, population-based approaches to the management of diabetes with cultural considerations that are relevant to the population of interest. This innovative approach is expected to yield the following outcomes. First, specific cultural impediments to effective treatment of type-2 diabetes in blacks will be identified in both-patients and their health-care providers, which will allow prospective targeting of these factors to improve diabetes outcomes. Second, it is expected that important components of collaborative care for blacks with type-2 diabetes will be identified despite cultural difference between patients and providers. Third, because of this mentored research experience, the principal investigative independence, with sufficient data to be competitive for R01 funding. Collectively, these outcomes are important, because they are expected to be competitive for R01 funding. Collectively, these outcomes are important, because they are expected to improve the diabetes outcomes of black Americans with type 2 diabetes and to the cadre of dedicated diabetes health services researchers.
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