# A Multiphase Optimization Strategy to Enhance Diabetes Management Interventions for Black and Hispanic Patients with Uncontrolled Diabetes

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2024 · $616,963

## Abstract

Black and Hispanic adults experience higher rates of diabetes-related morbidity and mortality than non-Hispanic
whites. One primary reason for this disparity is their poor adherence to diabetes medicines. Not only do Black
and Hispanic adults suffer more from complications related to uncontrolled diabetes than non-Hispanic whites,
but their medication adherence rates are lower as well. Also, these diabetes disparities are strongly driven by
social determinants of health (SDOH) barriers such as food insecurity, and health misperceptions - negative
beliefs about diabetes/medicines, that negatively impact Blacks and Hispanics ability to manage diabetes
including taking medicines. There is an immense need for effective diabetes self-management interventions that
improve health outcomes for Black and Hispanic adults and reduce disparities. Our interdisciplinary team of
experts in diabetes management interventions, medication adherence, health disparities, multiphase
optimization strategy trials, mixed methods, and cost-effectiveness analysis will partner with an established
pharmacy chain, and community partners to conduct a randomized factorial mixed methods trial to optimize
diabetes management in Black and Hispanic adults with uncontrolled diabetes. This partnership will lead to the
identification of an effective and cost-effective diabetes management intervention that reduces medication
nonadherence and improves glycemic control (HbA1c) for Black and Hispanic adults by testing theory-driven
intervention components/combination. This 6-month intervention will identify the intervention
components/combination of components, i.e., (1) medication therapy management optimizing medication
therapy, (2) community health workers addressing SDOH barriers to diabetes self-management and addressing
diabetes and medicine misperceptions, added to usual care, that are effective in improving diabetes outcomes
(effectiveness optimization) and are cost-effective (cost-effectiveness optimization). The expanded Chronic Care
Model and Leventhal’s Extended Common Sense Model will be used to explain the contextual factors that put
Black and Hispanic adults at a greater risk for diabetes disparities, and psychosocial and behavioral mechanisms
to be tested. A randomized factorial mixed methods trial will evaluate the main effect of each intervention
component and the interactions between intervention components to determine the optimal combination of
components, that will have a long-term effect on (1) HbA1c, (2) medication adherence (assessed using self-
report and pharmacy refills), and (3) psychosocial/sociocultural mediators of these outcomes. Finally, using
qualitative interviews, we will explore the acceptability of each intervention component/combination as well as
the effective/cost-effective components through understanding participant experiences. This project addresses
an unmet critical need to optimize effective and cost-effective diabetes self-management interv...

## Key facts

- **NIH application ID:** 10919825
- **Project number:** 5R01DK136690-02
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Michelle Anne Chui
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $616,963
- **Award type:** 5
- **Project period:** 2023-09-05 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10919825

## Citation

> US National Institutes of Health, RePORTER application 10919825, A Multiphase Optimization Strategy to Enhance Diabetes Management Interventions for Black and Hispanic Patients with Uncontrolled Diabetes (5R01DK136690-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10919825. Licensed CC0.

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