Project Grant R18HS029431

SINAI DIABETES CENTER - PROJECT SUMMARY SINAI CHICAGO (SINAI) IS ILLINOIS' LARGEST PRIVATE SAFETY-NET HEALTHCARE SYSTEM, SERVING PREDOMINANTLY LOW-INCOME COMMUNITIES OF COLOR WITH LARGE MEDICAID-ELIGIBLE POPULATIONS IN CHICAGO. IN RESPONSE TO HIGH DIABETES RATES AND COMMUNITY CALLS FOR COORDINATED, MULTIDISCIPLINARY DIABETES CARE, SINAI DESIGNED THE CENTER FOR DIABETES AND ENDOCRINOLOGY (THE CENTER) WHICH LAUNCHED IN 2020. THE CENTER USES A COMPREHENSIVE MODEL WITH STREAMLINED SERVICES TO ADDRESS THE FULL SPECTRUM OF PATIENT MEDICAL AND NON-MEDICAL NEEDS. WE PROPOSE A CONVERGENT MIXED-METHODS OPTIMIZATION STUDY TO DETERMINE THE APPROPRIATENESS AND FIDELITY OF THREE INTERVENTION COMPONENTS OF A TEAM- BASED CARE MODEL FOR PATIENTS SERVED BY THE CENTER TO DEFINE THE IDEAL SEQUENCE FOR IMPROVING PATIENT OUTCOMES. GROUNDED IN QUALITATIVE METHODOLOGY AND GUIDED BY A SEQUENTIAL MULTIPLE ASSIGNMENT RANDOMIZED TRIAL (SMART), WE PROPOSE EVALUATING THE APPROPRIATENESS OF NOVEL INTERVENTION ENHANCEMENTS (AIM 1); MEASURING FIDELITY OF NEW INTERVENTION ENHANCEMENTS (AIM 2); COMPARING THE EFFECTIVENESS AND DETERMINING OPTIMIZATION OF INTERVENTION ENHANCEMENTS (AIM 3). WE WILL EVALUATE AIM 1 VIA KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUPS. WE WILL ANALYZE AIMS 2 AND 3 BY CONDUCTING DESCRIPTIVE STATISTICS ON ALL VARIABLES, GIVING SPECIAL ATTENTION TO OUTLIER VALUES. WE WILL ALSO RUN BIVARIATE AND MULTIVARIATE ANALYSES ACROSS VARIABLES OF INTEREST AND TIME POINTS TO DETERMINE THE OPTIMAL SEQUENCE OF INTERVENTION ACTIVITIES. WE WILL DISSEMINATE OUR LEARNINGS BROADLY TO KEY STAKEHOLDERS THROUGH COMMUNITY FORUMS, PEER-REVIEWED PUBLICATIONS AND PRESENTATIONS. OUR MULTI-DISCIPLINARY TEAM HAS A WEALTH OF EXPERIENCE IN HEALTH SERVICES PROGRAMMING AS WELL AS RESEARCH AND EVALUATION. WE PROPOSE A 3 YEAR, $1.5 MILLION PROJECT FROM MARCH 2023 TO FEBRUARY 2026.