Diabetes-related health care for patients with limited English proficiency is fragmented, leading to poor health outcomes. The Center for Immigrant and Refugee Research and Clinical Evaluation, developed during our Tier I and II projects, will address this issue via the following comparative effectiveness research question:
How well does a 10-month-long, community-based intervention in which adult patients (older than 18) with type 2 diabetes and limited English proficiency (Spanish and Nepali speakers) receive diabetes self-management education and care coordination using secure messaging from a multidisciplinary team improve control of participants’ diabetes (HbA1c) and patient-reported outcomes (patient–clinician communication) in comparison with monthly group medical visits provided over a similar period?
During Tier III, we will adapt interventions included in the tested Dulce Wireless Tijuana study, originally conducted in a Spanish-language context, which addressed a similar question. We will use topical workgroups (conducted in Nepali and Spanish, separately) to discuss elements of that intervention, including whether and how to adapt them in our own study. Workgroup members will report the results of these discussions in bi-monthly World Cafe sessions, to receive feedback from other groups’ members. Project collaborators will receive summaries of these discussions and provide feedback as input into project decisions, which will be made by our partnership’s advisory panel. Our overall objective is to test the effectiveness of the interventions we are adapting in the US “language discordant” healthcare delivery context (where clinicians and patients do not speak the same language), as well as its effectiveness in a different ethnolinguistic group, Nepali-speaking Bhutanese newcomers.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.