# Dulce Digital-COVID Aware (DD-CA) discharge texting platform for US/Mexico border Hispanics with diabetes + COVID-19

> **NIH NIH R01** · SCRIPPS HEALTH · 2020 · $306,364

## Abstract

Project Summary
Hispanics, a group that shows higher type 2 diabetes (T2D) prevalence, and poor self-management and
clinical outcomes, have been disproportionally adversely impacted by COVID-19. The California Department of
Public Health reports that Hispanics make up 39% of California’s population but an unprecedented 57% of the
confirmed COVID-19 cases. This devastating finding is especially notable on the US/Mexico border. Diabetes
has emerged as a leading risk factor for severe COVID-19 illness leading to hospitalization, is associated with
greater disease severity and mortality and is an independent predictor of intensive care placement and
invasive ventilation. It is becoming increasingly clear that maintaining good glucose control improves prognosis
of COVID-19 among people with pre-existing T2D. However, social distancing, quarantine, and stay-at-
home/lockdown guidelines may impact one’s ability to maintain adequate glycemic control. Research is
needed to evaluate the effect and clinical outcomes of a flexible, easily adopted low cost digital intervention
that improves glucose excursions and provides urgently needed COVID-19 mitigation strategies, among
rapidly rising groups of high-risk Hispanics with poorly controlled T2D in US/Mexico border communities.
Strong evidence from our parent grant Dulce Digital-Me, supports the use of technology (such as text
messaging) alone or in combination with coaching interventions as a viable and desired method of delivering
tailored diabetes self-management education and COVID awareness messaging to high-risk, underserved
populations in a manner that is more convenient for both patients and staff while having the added benefit of
being cost-effective for health systems, especially within low resource settings. However, effective
interventions may encounter barriers which preclude guaranteed success upon implementation in the real
world. This project, taking place along the San Diego/Tijuana border, historically the busiest land port of entry
in the Western Hemisphere, will assess the effect of providing an enhanced digital texting intervention-Dulce
Digital-COVID Aware (DD-CA) to N = 172 Hispanic patients with T2D upon discharge from a recent
hospitalization. Key outcomes will assess the impact of DD-CA on hospital readmissions at 30 and 90 days
post-discharge, glucose control and patient reported outcomes at 90 days post-discharge while also assessing
COVID status and the implementation process. Given that DD-CA offers the potential to address many of the
practical barriers to access and extend the reach of diabetes services, while additionally providing COVID
awareness support, it offers an ideal low-cost and flexible solution to reduce hospital admissions and re-
admissions in US/Mexico border communities significantly and simultaneously affected by COVID-19 and T2D.
Implemented in a typical hospital and post-discharge setting, it augments existing care team processes, thus
providing a valuable te...

## Key facts

- **NIH application ID:** 10215100
- **Project number:** 3R01DK112322-05S1
- **Recipient organization:** SCRIPPS HEALTH
- **Principal Investigator:** Adelaide L Fortmann
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $306,364
- **Award type:** 3
- **Project period:** 2016-09-20 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10215100

## Citation

> US National Institutes of Health, RePORTER application 10215100, Dulce Digital-COVID Aware (DD-CA) discharge texting platform for US/Mexico border Hispanics with diabetes + COVID-19 (3R01DK112322-05S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10215100. Licensed CC0.

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