This Mentored Patient-Oriented Research Career Development Award (K23) provides intensive training and time to gain necessary skills and knowledge toward achieving Dr. Kathryn Kanzler’s long-term goal of being an independent clinical investigator of scalable behavioral treatments to reduce health disparities and improve outcomes for patients with diabetes. This study helps address an urgent need for more interventions for the Hispanic/Latino diabetes population.
Despite continued biomedical advances, diabetes and related complications continue to take a higher toll in the Hispanic/Latino community, where there is 40% greater likelihood of death compared to non-Hispanic whites. Avoidance coping has emerged as a key factor in preventing optimal glycemic control, but interventions that address avoidance coping, such as Acceptance and Commitment Therapy (ACT), are limited by language and cultural barriers to care, as well as standard dissemination practices. Community health workers (“Promotores”) serving on primary care teams could deliver key elements of ACT for diabetes, in addition to mitigating other barriers to self-management. Task-shifting core skills of ACT–Acceptance Based Coping (ABC) skills—to supervised Promotores could provide accessible and culturally appropriate treatment in the preferred language of patients.
This study aims to develop an acceptable and feasible Promotores-delivered ABC intervention program for Hispanics/Latinos using REP pre-conditions and pre-implementation steps, in (a) qualitative and quantitative data from interviews and focus groups; and (b) repeated small-sample beta-tests. This line of research has potential to improve glycemic control and quality of life for Hispanic/Latino patients with Type 2 Diabetes.
Project Period: September 2019 – June 2023
PI: Kathryn Kanzler, PsyD, ABPP