이민자의 건강에 대한 사회적 결정 요인을 다루기 위해 비디오와 지역 사회 보건 종사자를 활용 (LINK-IT)

실험적: 동영상

VIDEO 부문에 배정된 참가자는 24주 동안 매주 간단한 당뇨병 자가 관리 교육 및 지원(DSMES) 비디오 1개를 받게 됩니다. 영상은 문자 메시지로 전달됩니다.

행동: 비디오 기반 당뇨병 자가 관리 교육 및 지원(DSMES)

DSMES 비디오는 참가자들에게 중요한 당뇨병 교육을 제공하고 그들이 개인 수준에서 활성화된 환자가 되도록 힘을 실어줍니다.

실험적: 비디오+CHW

VIDEO+CHW 부서에 배정된 참가자는 24주 동안 지역사회 의료 종사자(CHW)의 격주 지원 전화 외에 매주 간단한 DSMES 비디오 1개를 받게 됩니다. DSMES 영상은 문자 메시지로 전달됩니다.

행동: 비디오 기반 당뇨병 자가 관리 교육 및 지원(DSMES)

DSMES 비디오는 참가자들에게 중요한 당뇨병 교육을 제공하고 그들이 개인 수준에서 활성화된 환자가 되도록 힘을 실어줍니다.

행동: 지역사회 보건 종사자(CHW) 지원

CHW는 제2형 당뇨병 치료에 대한 참가자의 SDOH(사회적 건강 결정 요인) 장벽을 평가하고 이를 지역 사회에서 이용 가능한 자원과 연결합니다.

간섭 없음: CONTROL

Participants assigned to the CONTROL group will continue to receive usual care. At the end of the study, they will receive DSMES videos.

헤모글로빈 A1c(HbA1c) 수치

헤모글로빈 A1c(HbA1c) 수치

헤모글로빈 A1c(HbA1c) 수치

국제 신체 활동 설문지(IPAQ) 단기 버전 점수

참가자는 격렬한 활동, 중간 정도의 활동, 걷기 활동 등 세 가지 신체 활동 범주에 참여하여 주당 추정 시간(분)을 제공하는 자가 평가를 수행합니다. 결과는 주당 대사량(MET) 분으로 표시됩니다. MET 분은 신체 활동을 수행하는 데 소비되는 에너지의 양을 나타냅니다. MET 계산 공식은 다음과 같습니다: 8(강한 활동)(분) + 4(보통 활동)(분) +3.3(걷기 활동)(분) = MET.

MET 점수가 높을수록 주간 신체 활동 수준이 높다는 것을 의미합니다.

국제 신체 활동 설문지(IPAQ) 단기 버전 점수

참가자는 격렬한 활동, 중간 정도의 활동, 걷기 활동 등 세 가지 신체 활동 범주에 참여하여 주당 추정 시간(분)을 제공하는 자가 평가를 수행합니다. 결과는 주당 대사량(MET) 분으로 표시됩니다. MET 분은 신체 활동을 수행하는 데 소비되는 에너지의 양을 나타냅니다. MET 계산 공식은 다음과 같습니다: 8(강한 활동)(분) + 4(보통 활동)(분) +3.3(걷기 활동)(분) = MET.

MET 점수가 높을수록 주간 신체 활동 수준이 높다는 것을 의미합니다.

국제 신체 활동 설문지(IPAQ) 단기 버전 점수

참가자는 격렬한 활동, 중간 정도의 활동, 걷기 활동 등 세 가지 신체 활동 범주에 참여하여 주당 추정 시간(분)을 제공하는 자가 평가를 수행합니다. 결과는 주당 대사량(MET) 분으로 표시됩니다. MET 분은 신체 활동을 수행하는 데 소비되는 에너지의 양을 나타냅니다. MET 계산 공식은 다음과 같습니다: 8(강한 활동)(분) + 4(보통 활동)(분) +3.3(걷기 활동)(분) = MET.

MET 점수가 높을수록 주간 신체 활동 수준이 높다는 것을 의미합니다.

Stanford Self-Efficacy for Diabetes Scale Score

8-item self-assessment of participants' confidence level in performing specific self-management behaviors. Items are ranked on a 10-point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). The total score can be calculated by summing the 8 item scores (range, 8-80), with higher scores indicating greater self-efficacy.

Stanford Self-Efficacy for Diabetes Scale Score

8-item self-assessment of participants' confidence level in performing specific self-management behaviors. Items are ranked on a 10-point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). The total score can be calculated by summing the 8 item scores (range, 8-80), with higher scores indicating greater self-efficacy.

Stanford Self-Efficacy for Diabetes Scale Score

8-item self-assessment of participants' confidence level in performing specific self-management behaviors. Items are ranked on a 10-point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). The total score can be calculated by summing the 8 item scores (range, 8-80), with higher scores indicating greater self-efficacy.

Starting the Conversation (STC) Diet Scale Score

8-item self-report questionnaire measuring dietary behaviors. Scores range from 0 to 16; lower scores indicate healthier eating behaviors.

Starting the Conversation (STC) Diet Scale Score

8-item self-report questionnaire measuring dietary behaviors. Scores range from 0 to 16; lower scores indicate healthier eating behaviors.

Starting the Conversation (STC) Diet Scale Score

8-item self-report questionnaire measuring dietary behaviors. Scores range from 0 to 16; lower scores indicate healthier eating behaviors.

Adherence to Refills and Medications Scale for Diabetes (ARMS-D)

ARMS-D is an 11-item questionnaire used to assess medication-taking adherence at baseline, 6 months, and 12 months. Responses range from 1 ("none of the time") to 4 ("all of the time"). Item scores are summed to produce an overall adherence score ranging from 11 to 44, with higher scores indicating more problems with medication adherence.

Adherence to Refills and Medications Scale for Diabetes (ARMS-D)

ARMS-D is an 11-item questionnaire used to assess medication-taking adherence at baseline, 6 months, and 12 months. Responses range from 1 ("none of the time") to 4 ("all of the time"). Item scores are summed to produce an overall adherence score ranging from 11 to 44, with higher scores indicating more problems with medication adherence.

Adherence to Refills and Medications Scale for Diabetes (ARMS-D)

ARMS-D is an 11-item questionnaire used to assess medication-taking adherence at baseline, 6 months, and 12 months. Responses range from 1 ("none of the time") to 4 ("all of the time"). Item scores are summed to produce an overall adherence score ranging from 11 to 44, with higher scores indicating more problems with medication adherence.

Emotional Support Subscale from the NIH Toolbox Adult Social Relationship Scales

8-item subscale to assess individuals' perceptions of empathy and understanding received from others in their social network at baseline, 6 months, and 12 months.

Emotional Support Subscale from the NIH Toolbox Adult Social Relationship Scales

8-item subscale to assess individuals' perceptions of empathy and understanding received from others in their social network at baseline, 6 months, and 12 months.

Emotional Support Subscale from the NIH Toolbox Adult Social Relationship Scales

8-item subscale to assess individuals' perceptions of empathy and understanding received from others in their social network at baseline, 6 months, and 12 months.

Diabetes-Related Distress

Diabetes-related distress will be assessed using the 2-item Diabetes Distress Screening Scale (DDS-2), a validated screening instrument that measures the emotional burden and stress associated with living with diabetes. Each item is rated on a 6-point Likert scale (1 = "Not a problem" to 6 = "A very serious problem"). The overall score is calculated as the mean of the two items, with higher scores indicating greater diabetes-related distress.

Diabetes-Related Distress

Diabetes-related distress will be assessed using the 2-item Diabetes Distress Screening Scale (DDS-2), a validated screening instrument that measures the emotional burden and stress associated with living with diabetes. Each item is rated on a 6-point Likert scale (1 = "Not a problem" to 6 = "A very serious problem"). The overall score is calculated as the mean of the two items, with higher scores indicating greater diabetes-related distress.

Diabetes-Related Distress

Diabetes-related distress will be assessed using the 2-item Diabetes Distress Screening Scale (DDS-2), a validated screening instrument that measures the emotional burden and stress associated with living with diabetes. Each item is rated on a 6-point Likert scale (1 = "Not a problem" to 6 = "A very serious problem"). The overall score is calculated as the mean of the two items, with higher scores indicating greater diabetes-related distress.

SDOH Barriers

The 14-item SDOH questionnaire assessed core health-related barriers across five domains: economic stability (e.g., food access and housing stability), education access and quality (e.g., need to improve English proficiency, reading skills, or educational attainment), health care access and quality (e.g., insurance coverage), neighborhood and built environment (e.g., housing conditions), and social and community context (e.g., racial discrimination; need for childcare; and need for assistance addressing tobacco, alcohol, or drug use). Items used dichotomous response options (1 = "Yes"; 0 = "No"). An overall SDOH score was calculated by summing responses across the 14 items (range: 0-14), with higher scores indicating greater SDOH-related barriers.

SDOH Barriers

The 14-item SDOH questionnaire assessed core health-related barriers across five domains: economic stability (e.g., food access and housing stability), education access and quality (e.g., need to improve English proficiency, reading skills, or educational attainment), health care access and quality (e.g., insurance coverage), neighborhood and built environment (e.g., housing conditions), and social and community context (e.g., racial discrimination; need for childcare; and need for assistance addressing tobacco, alcohol, or drug use). Items used dichotomous response options (1 = "Yes"; 0 = "No"). An overall SDOH score was calculated by summing responses across the 14 items (range: 0-14), with higher scores indicating greater SDOH-related barriers.

SDOH Barriers

The 14-item SDOH questionnaire assessed core health-related barriers across five domains: economic stability (e.g., food access and housing stability), education access and quality (e.g., need to improve English proficiency, reading skills, or educational attainment), health care access and quality (e.g., insurance coverage), neighborhood and built environment (e.g., housing conditions), and social and community context (e.g., racial discrimination; need for childcare; and need for assistance addressing tobacco, alcohol, or drug use). Items used dichotomous response options (1 = "Yes"; 0 = "No"). An overall SDOH score was calculated by summing responses across the 14 items (range: 0-14), with higher scores indicating greater SDOH-related barriers.

Health-Related Social Needs

Health-related social needs (HRSNs) will be assessed using the 26-item The Accountable Health Communities Health-Related Social Needs Screening Tool. The instrument assesses unmet health-related social needs across 13 domains, including housing instability, food insecurity, transportation needs, utility assistance needs, interpersonal safety, financial strain, employment, family and community support, education, physical activity, substance use, mental health, and disability. These domains identify social needs that may be addressed through clinical and community-based services. Each domain includes its own set of indicators. Descriptive statistics will be used to summarize the data, with frequencies and percentages reported for categorical variables. For domains with continuous or summed measures, composite scores will be calculated by summing the relevant items, with higher scores indicating greater unmet health-related social needs.

Health-Related Social Needs

Health-related social needs (HRSNs) will be assessed using the 26-item The Accountable Health Communities Health-Related Social Needs Screening Tool. The instrument assesses unmet health-related social needs across 13 domains, including housing instability, food insecurity, transportation needs, utility assistance needs, interpersonal safety, financial strain, employment, family and community support, education, physical activity, substance use, mental health, and disability. These domains identify social needs that may be addressed through clinical and community-based services. Each domain includes its own set of indicators. Descriptive statistics will be used to summarize the data, with frequencies and percentages reported for categorical variables. For domains with continuous or summed measures, composite scores will be calculated by summing the relevant items, with higher scores indicating greater unmet health-related social needs.

Health-Related Social Needs

Health-related social needs (HRSNs) will be assessed using the 26-item The Accountable Health Communities Health-Related Social Needs Screening Tool. The instrument assesses unmet health-related social needs across 13 domains, including housing instability, food insecurity, transportation needs, utility assistance needs, interpersonal safety, financial strain, employment, family and community support, education, physical activity, substance use, mental health, and disability. These domains identify social needs that may be addressed through clinical and community-based services. Each domain includes its own set of indicators. Descriptive statistics will be used to summarize the data, with frequencies and percentages reported for categorical variables. For domains with continuous or summed measures, composite scores will be calculated by summing the relevant items, with higher scores indicating greater unmet health-related social needs.

Cognitive Function

Cognitive function will be assessed using the Mini-Montreal Cognitive Assessment (Mini-MoCA), a validated 15-point screening instrument for the rapid detection of mild cognitive impairment. Total scores range from 0 to 15, with higher scores indicating better cognitive function. A score below 11 may indicate cognitive impairment and warrant further evaluation.

Cognitive Function

Cognitive function will be assessed using the Mini-Montreal Cognitive Assessment (Mini-MoCA), a validated 15-point screening instrument for the rapid detection of mild cognitive impairment. Total scores range from 0 to 15, with higher scores indicating better cognitive function. A score below 11 may indicate cognitive impairment and warrant further evaluation.

Cognitive Function

Cognitive function will be assessed using the Mini-Montreal Cognitive Assessment (Mini-MoCA), a validated 15-point screening instrument for the rapid detection of mild cognitive impairment. Total scores range from 0 to 15, with higher scores indicating better cognitive function. A score below 11 may indicate cognitive impairment and warrant further evaluation.