Research at the NYU-CUNY Prevention Research Center (NYU-CUNY PRC), a partnership between NYU Langone and the CUNY Graduate School of Public Health and Health Policy, advances the study of innovative combinations of community- and clinic-based interventions for improved linkage to preventive care and chronic disease prevention and management.

In our fourth consecutive five-year funding cycle, spanning 2024 to 2029, we are accelerating the translation of evidence-based and innovative programs to increase access to care and disrupt the cycle of health disparities.

Our completed core research projects include evaluations of the New York City Health Justice Network and the Harlem Health Advocacy Partners program, Implementing Million Hearts for Provider and Community Transformation (Project IMPACT), and Reaching Immigrants through Community Empowerment (Project RICE).

Increasing the Uptake of Diabetes Self-Management Education and Support Programs and Addressing Social Needs (INSPIRE) Study

The INSPIRE study, led by Brita Roy, MD, MPH, Terry Huang, PhD, MPH, MBA, and Lu Hu, PhD, is investigating the adoption and effectiveness of a technology-enabled and community health worker (CHW)-supported intervention on diabetes control among low-income adults. The intervention is designed to first address patients’ social needs alongside clinical care, creating an integrated community-clinical interface, then followed by digital delivery of a diabetes self-management education and support (DSMES) program.

Type 2 diabetes mellitus (T2DM) is a nationwide epidemic with a significant burden on patients, health systems, and society; it’s the eighth leading cause of death and disability in the US, affecting over 33 million individuals each year. DSMES is an evidence-based intervention to improve T2DM control. Led by a diabetes educator, DSMES provides guidance on and support for healthy eating and physical activity, helps patients monitor blood glucose and adhere to medications, as well as helps improve patients’ psychosocial well-being. Compared with patients who receive the usual care, these programs result in a larger reduction of hemoglobin A1c (HbA1c). Despite these potential benefits, only a small percentage of patients newly diagnosed with T2DM participate in DSMES and completion rates remain low.

There are many barriers to DSMES uptake and diabetes control among low-income populations, including inattention to social determinants of health (SDOH); lack of integration within and support from healthcare systems to link patients to DSMES programs; patient concerns about cost, time and transportation of DSMES programs; and language and cultural discordance of DSMES programs. The INSPIRE study will address these barriers and improve patients’ ability to participate in DSMES and manage their diabetes.

The INSPIRE study aims to:

• Identify facilitators and barriers to the implementation process and to assess patient uptake of specific DSMES delivery strategies, provider adoption, and program acceptability, appropriateness, feasibility, fidelity, reach and maintenance;
• Examine the effectiveness of technology- and CHW-enabled community-clinical linkage on reducing HbA1c, the effectiveness of additional culturally- and linguistically-tailored DSMES videos on sustaining or further improving glycemic control, as well as psychosocial and behavioral outcomes; and
• Assess and improve the sustainability and scale-up of the implementation package and model its long-term effectiveness on reducing T2DM morbidity and mortality.

Despite the high burden of T2DM, no roadmap or care model exists to guide the translation, implementation, and scaling of strategies to mitigate implementation gaps affecting the targeted populations. The INSPIRE study will develop CHW toolkits, culturally tailored DSMES videos, and simulation models to help address these implementation gaps for other health systems to improve T2DM care in their local contexts.