Diabetes Mellitus Self-Management in Minority Populations.

This program announcement solicits applications for investigator-initiated research related to socio-cultural, environmental, and behavioral mechanisms and biological/technological factors that contribute to successful and ongoing self-management of diabetes mellitus in minority populations. Applications that expand accepted intervention strategies in majority populations to minority populations are encouraged. Testing new interventions designed to promote self-management in minority diabetes populations will also be considered responsive to the announcement. Self-management is defined as client strategies and behaviors that contribute to blood glucose normalization, improved health, and prevention or reduction of complications; the concept is broader than adherence to specific regimen components and incorporates deliberate problem solving and decision making processes. Applications are encouraged for both type 1 and type 2 diabetes and all age groups.

The target populations are ethnic minorities, although comparison studies may include a Caucasian group when warranted and when sample sizes are proportionate. Intervention proposals are solicited, especially those to test accepted strategies not adequately evaluated in minority populations.

The following research topics are provided as examples that would extend research currently funded by NIH. They are not listed in any priority order and are not intended to be inclusive or restrictive: 1) determine ways to accurately measure cultural/ethnic differences in self-management behaviors; 2) determine the influence of particular cultural/ethnic group differences in diabetes self-management behaviors and outcomes (for example, variations in blood glucose testing, symptom management, healthy behaviors); 3) evaluate interventions for minority children or adolescents that incorporate family, health care providers, school staff, support systems, and psychosocial factors; 4) identify culture- or ethnic-specific facilitators and barriers relevant to self-management across the life span; 5) investigate the influence of age, diet, education, environment, financial status, and physical activity in diabetes self-management in minority ethnic groups; 6) investigate the efficacy of academic or health care provider agency collaborations with community-based organizations in the implementation of and adherence to self-management protocols, as this relates to social support mechanisms (i.e., social capital, which may be defined as social interactions that positively impact individuals and/or communities); 7) determine the influence of social support, burden of care, coping skills, quality of life, and self-efficacy on diabetes self-management in minority groups; 8) test interventions previously shown to be effective and efficacious in majority populations within or across minority ethnic populations; 9) test interventions and delivery systems that involve minority populations in active participation in self-management and related problem solving; 10) examine physiological, genetic, and environmental factors that affect response to metabolic control and self-management in minority populations; 11) determine the efficacy of technologies associated with self-management in minority populations (for example, glucose monitoring, computer-based communications and strategies, insulin pumps); and 12) evaluate the influence of neighborhood characteristics on self-management capabilities (e.g., available venues for safe indoor and outdoor exercise and accessibility of fresh produce and other health-promoting foods).

Applications are to be submitted on grant application form PHS 398 (rev. 4/98) and will be accepted at the standard application deadlines as indicated in the application kit. Additional information is available on the Internet at http://grants.nih.gov/grants/ guide/pa-flies/PA-00-113.html.

Contact: Nell Armstrong, Division of Extramural Activities, National Institute of Nursing Research, Building 45, Room Number 3AN12, MSC 6300, Bethesda, MD 20892-6300 USA, 301-5945973, fax: [phone], e-mail: [e-mail]. Reference: PA No. PA-00-113