# Using Peer Navigators to increase access to VA and community resources for Veterans with diabetes-related distress

> **NIH VA I01** · MICHAEL E DEBAKEY VA MEDICAL CENTER · 2022 · —

## Abstract

Diabetes-related distress, the negative emotional impact of living with diabetes (DM), is a powerful predictor of
psychosocial functioning, treatment adherence, and glycemic control. Practice guidelines and consensus
statements call for innovative approaches to address DM-related distress. Despite availability of self-
management and psychosocial interventions to reduce DM related distress, these interventions are
underutilized due to constraints in time, finances, motivation, and resource-awareness. Interventions that
leverage traditional medical care and community-based health promotion programs (e.g., DM self-
management education (DSME) programs) may enhance the ability of Veterans with DM to engage with a
broad and accessible range of resources. Ensuring that Veterans with DM receive adequate self-care support
requires interventions that (1) attend to both medical care and diabetes-related distress and (2) improve
Veterans' access and engagement with DSME and traditional medical/mental care. Integrating VA and
community health services and DSME resources is innovative and affords great opportunities to enhance
Veteran outcomes and build VA community partnerships. Engagement of Veterans and community
organizations in developing and delivering care responds to the 2016 HSR&D high-priority domain of Health
Care Systems Change and aligns with the 2017 VA Under Secretary's priorities of Greater Choice
(offering community and VA resources), Efficiency (community and VA coordination), and Timeliness
(telephone delivery).
This community-VA partnership and three-month Veteran peer coaching intervention (iNSPiRED) aims to
enhance psychological well-being and diabetes self-management behavior in Veterans with DM by facilitating
access to and use of healthcare and health promotion resources. The intervention focuses on reducing
cognitive and practical barriers to use of services by engaging Veteran peers as coaches and navigators, and
by encouraging engagement in health promotion and healthcare services in the VA and the greater community.
A secondary goal, integral to the main goal, is to strengthen and integrate VHA partnerships with community-
based organizations and Veteran Support Organizations (VSO's).
This is a single-blind, parallel group randomized trial of a 3-month peer navigation intervention for Veterans
with DM and elevated levels of DM-related distress. We will recruit Veterans with DM-related distress through
existing help-seeking channels within and outside of the VA in partnership with community agencies, VSO's,
and the Houston VAMC. Eligible Veterans will be assigned at random to the iNSPiRED intervention (peer
navigation and coaching) versus usual care (written resource materials and encouragement to continue follow-
up with healthcare providers). Consistent with the focus on the overall emotional impact of DM, the PRIMARY
OUTCOME is DM-related distress (DM Distress Scale). In previous studies the DDS has shown strong
relationships w...

## Key facts

- **NIH application ID:** 10406911
- **Project number:** 5I01HX002580-04
- **Recipient organization:** MICHAEL E DEBAKEY VA MEDICAL CENTER
- **Principal Investigator:** Mark E. Kunik
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-05-01 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10406911

## Citation

> US National Institutes of Health, RePORTER application 10406911, Using Peer Navigators to increase access to VA and community resources for Veterans with diabetes-related distress (5I01HX002580-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10406911. Licensed CC0.

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