# REACH-Es: Adapting a digital health tool to improve diabetes medication adherence among Latino adults

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $195,355

## Abstract

PROJECT SUMMARY
Background: Latino adults have a disproportionate burden of type 2 diabetes and diabetes-related
complications. Diabetes medication non-adherence is an important modifiable contributor to suboptimal
glycemic management among Latino adults, who are nearly twice as likely to report non-adherence to diabetes
medications as non-Hispanic White individuals. Besides language barriers, additional commonly reported
barriers that contribute to non-adherence in this population include negative perceptions about insulin use and
misunderstanding ongoing need for diabetes medications once HbA1c has improved. Mobile health (mHealth)
technology can reduce medication adherence barriers and improve adherence behavior, but mHealth tools that
address commonly reported barriers to diabetes medication adherence among Latino adults are lacking.
Candidate: I am an endocrinologist born and raised in Latin America; my long-term career goal is to develop
scalable, patient-centered interventions that address gaps in diabetes self-care to improve outcomes among
Latino adults with type 2 diabetes. Training: I have received outstanding research training in epidemiology but
to achieve my long-term career goal I require additional training in: 1) adaptation of evidence-based
interventions, 2) mixed methods, and 3) conduct of clinical trials in mHealth. Mentors: My training and
research plans will be overseen by Primary Mentor Dr. Deborah Wexler (type 2 diabetes clinical
trials/intervention adaptation) and Co-Mentor Dr. Lindsay Mayberry (mixed methodologist/mHealth clinical
trials). Drs. Margarita Alegria (behavioral intervention adaptation to a Latino population), Enrique Caballero
(cultural tailoring of diabetes interventions to a Latino population), J. Jaime Miranda (mHealth intervention
development/testing in Latino populations), and Tanayott Thaweethai (biostatistics) will provide additional
focused expertise. Research: I will adapt REACH, a text message-based mHealth platform with content
tailored to address self-reported barriers to diabetes medication adherence (developed by Dr. Mayberry), to a
Latino population (REACH-Español) with type 2 diabetes through two specific aims. Aim 1: Adapt and develop
REACH-Es content on barriers to diabetes medication adherence with engagement of a diverse group of
stakeholders (n=8), qualitative input from Latino adults with type 2 diabetes (n=20-30), and beta testing for
intervention refinement with stakeholder input. Aim 2: Conduct a pilot RCT (n=70) to assess feasibility,
acceptability, and usability of REACH-Es, as well as intervention targets (diabetes medication adherence and
barriers to adherence) comparing REACH-Es to control; secondary outcomes are HbA1c and diabetes self-
efficacy. The project will generate preliminary data for an R01 hybrid-effectiveness implementation trial of
REACH-Es. The completion of these training and scientific aims will facilitate my transition to becoming an
independent physician-invest...

## Key facts

- **NIH application ID:** 10811692
- **Project number:** 5K23DK135798-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Jacqueline Anne Seiglie
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $195,355
- **Award type:** 5
- **Project period:** 2023-04-01 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10811692

## Citation

> US National Institutes of Health, RePORTER application 10811692, REACH-Es: Adapting a digital health tool to improve diabetes medication adherence among Latino adults (5K23DK135798-02). Retrieved via AI Analytics 2026-06-06 from https://api.ai-analytics.org/grant/nih/10811692. Licensed CC0.

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