# Basic Needs Navigation Intervention to Address Multidimensional Adversity in African Americans with Diabetic Kidney Disease

> **NIH NIH R21** · MEDICAL COLLEGE OF WISCONSIN · 2022 · $191,282

## Abstract

PROJECT SUMMARY
 Approximately 1 in 3 adults with diabetes have chronic kidney disease commonly referred to as diabetic
kidney disease (DKD). DKD is the leading cause of end stage renal disease in the United States. African
Americans are a vulnerable subgroup, as they are more likely to develop type 2 diabetes mellitus, have a 22%
higher risk of developing chronic kidney disease (CKD) and are almost four times more likely to progress to
ESRD compared to non-Hispanic whites (NHW). In addition, CKD is disproportionately prevalent in African
Americans living in poverty and they have a four-fold higher risk of developing ESRD compared to NHW.
Challenges of living in poverty include multidimensional adversity, defined as having three or more social
adversities such as housing instability, food insecurity, transportation needs, utility needs, interpersonal safety,
and financial strain. Multidimensional adversity impacts the complex self-management of DKD and negatively
impacts health outcomes. The constellation of living in poverty, being African American, having DKD and
multidimensional adversity results in poor outcomes. Patient education and self-management behaviors
including self-monitoring, lifestyle changes (e.g., eating and exercise habits) and medication adherence
represent the cornerstone of managing and optimizing clinical outcomes in individuals with DKD. Research
shows well-designed educational interventions improves knowledge, self-management, and patient outcomes.
However, evidence suggests that African Americans are less likely to perform self-management behaviors
compared to NHW and that interventions designed to improve self-management behaviors may have variable
effectiveness due to multidimensional adversity. Evidence suggests patient navigation programs may be a
promising strategy to improve health outcomes and address multidimensional adversity among individuals
living in poverty. An important unanswered question is whether a basic needs navigation intervention that
addresses multidimensional adversity in combination with patient education and lifestyle coaching leads to
improved clinical and patient-centered outcomes. In addition, we do not know whether integrating social
adversity into intervention studies can help reduce health disparities in clinical outcomes for chronic diseases
in minority populations. Preliminary data from our group suggest a novel intervention that incorporates DKD
education, basic needs navigation, and lifestyle coaching to address multidimensional adversity may be
effective in this population. Therefore, using a randomized control trial this R21 proposal will address a number
of gaps in our current knowledge in low-income African Americans with DKD experiencing multidimensional
adversity. It will also provide preliminary data for a large-scale appropriately powered, randomized clinical trial
(R01) focused on multidimensional adversity in African Americans with DKD. The long-term goal of this project
is t...

## Key facts

- **NIH application ID:** 10492585
- **Project number:** 5R21DK131356-02
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Mukoso N Ozieh
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $191,282
- **Award type:** 5
- **Project period:** 2021-09-22 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10492585

## Citation

> US National Institutes of Health, RePORTER application 10492585, Basic Needs Navigation Intervention to Address Multidimensional Adversity in African Americans with Diabetic Kidney Disease (5R21DK131356-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10492585. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*