# TELE Para DM: Telemedicine Equity for Limited English Proficient Patients with Diabetes Mellitus in the Safety Net

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2022 · $175,392

## Abstract

Project Summary/Abstract
Telemedicine (remote telephone and video health visits) is a digital health tool that can increase access to care
and improve health outcomes. Telemedicine care has been critical to maintaining healthcare access when in-
person care is disrupted, and the arrival of the Coronavirus-19 disease (COVID-19) pandemic forced the
integration of telemedicine into care almost overnight. But this is problematic for safety net health systems who
disproportionately provide care to racial/ethnic minority and Limited English Proficient (LEP) patients, who have
faced significant barriers with past digital health technology. In this K23, we will study telemedicine in the Los
Angeles County Department of Health Services (LAC DHS)— the second largest safety net in the United
States. We will focus on a particularly vulnerable population with need for frequent, interval care: patients with
diabetes mellitus (DM), specifically addressing LEP Spanish-speakers, who are 62% of the DM patients at LAC
DHS. This K23 proposal will investigate differences in factors affecting telemedicine use and explore
associated quality of diabetic care via quantitative and qualitative analyses among Spanish- and English-
speaking primary care patients (Aim 1). In partnership with the LAC DHS Virtual Care Workgroup, these
analyses will inform the tailored design of a patient coaching intervention in Spanish and in English to increase
and facilitate telemedicine use (Aim 2) and a pilot randomized controlled trial of the bilingual intervention (Aim
3). These aims will be achieved using mixed methods, implementation science, and digital health disparities
conceptual frameworks as they address the NIMHD research priority areas of developing interventions to
improve access to care for vulnerable patients and reduce health disparities. The studies are novel given the
timely focus on telemedicine implementation for vulnerable patient populations, addressing LEP patients
explicitly, as well as the proposed use of mixed methods to develop a theory-driven intervention. The proposed
studies are informed by Dr. Alejandra Casillas’ role as a primary care physician and her patient portal research
experience in diverse, urban primary care settings. Dr. Casillas’ long-term goal is to develop interventions that
reduce digital health disparities, increase health access, and improve health outcomes for racial/ethnic minority
and LEP patients. During the course of this award, Dr. Casillas will undertake didactic and experiential training
to improve knowledge and skills in three areas: (1) mixed methods in digital health disparities research, (2)
telemedicine delivery in the safety net, and (3) evaluation of pilot trial interventions in real-world clinical settings
using implementation science methods. Dr. Casillas has assembled a multi-institutional mentorship team with
the complementary expertise to ensure completion of the proposed research and training and successful
transition to ...

## Key facts

- **NIH application ID:** 10352045
- **Project number:** 1K23MD016943-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** ALEJANDRA CASILLAS
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $175,392
- **Award type:** 1
- **Project period:** 2022-03-30 → 2023-04-19

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10352045

## Citation

> US National Institutes of Health, RePORTER application 10352045, TELE Para DM: Telemedicine Equity for Limited English Proficient Patients with Diabetes Mellitus in the Safety Net (1K23MD016943-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10352045. Licensed CC0.

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