[R01] Supporting Monitoring and Remote Tracking for Prediabetes (SMART Prediabetes)
Ente: National Institute of Diabetes and Digestive and Kidney Diseases
Scadenza: 2031-06-30
Importo max: 784.276 EUR
Paese: US
Descrizione
PROJECT SUMMARY
For individuals with prediabetes, continuous glucose monitors (CGMs) are currently not covered by health
insurance. While available over the counter ($99 for two, 14-day sensors), many FQHC populations may be
unable to afford them, or understand the value they provide. Evidence abounds on the role of Community
health Workers (CHWs) in connecting safety-net populations with appropriate services and promoting chronic
disease prevention and management. However, CHWs in FQHC settings, themselves, may have limited
understanding of how CGMs work, and therefore require targeted training to effectively support patients in
using these devices. This discrepancy is associated with barriers to effective self-management, lower
utilization of monitoring technology, and increased risk of progression from prediabetes to diabetes. Building on
our prior work establishing feasibility and acceptability of CGM use in FQHC patients with diabetes, we will
evaluate the impact of CGM use on glycemic awareness, behavioral modification, and change in HbA1c,
compared to standard care. To ensure pragmatic relevance, each study arm will be stratified by receipt of
pharmacologic therapy (e.g., metformin, GLP-1 receptor agonists), to reflect real-world contexts. Our second
aim will identify multi-level barriers and facilitators to sustained CGM adoption, guided by Consolidated
Framework for Implementation Research (CFIR) and the Capability, Opportunity, Motivation–Behavior (COM-
B) model. Because the proposed interventions are aligned with real-world healthcare delivery, findings from
this study will generate actionable evidence to inform practice, supporting the integration of technology-
enabled care into prediabetes management. Research of this nature is critical to ensure that advances in
remote monitoring enhance access and outcomes for safety-net populations, rather than inadvertently
widening existing gaps.
Istituzione: UNIVERSITY OF HOUSTON
PI: Omolola E Adepoju
Progetto: 1R01DK149274-01
Settori: National Institute of Diabetes and Digestive and Kidney Diseases
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