Examining the Impact of Stories for Change - Diabetes

Hispanic/Latinx Americans are disproportionately impacted by type 2 diabetes (T2D) due, in part, to structural factors that lead to lower physical activity levels, dietary quality, medication adherence, and glucose self-monitoring than non-Hispanic White populations. To eliminate these disparities, culturally tailored interventions that enhance acceptance of healthy behaviors and improve T2D outcomes are needed. One intervention that has the potential to be successful is digital storytelling (DST) (see Stories for Change - Diabetes). Through DST interventions, participants gain knowledge that informs behavior change which in turn enhances their healthcare outcomes and reduces illness. It is not known whether and how individual characteristics or disease type may influence how individuals respond to a tailored digital story. This project builds on Stories for Change (S4C) by evaluating how the impact of a DST intervention is influenced by sociodemographic factors such as age, gender, social support, knowledge, and T2D disease characteristics among Hispanic/Latinx populations.

We performed a secondary analysis to identify sociodemographic and disease status characteristics that influenced how participants respond to S4C. We analyzed results from S4C intervention participants (n=228), stratified by whether they experienced a clinically meaningful decrease (>0.5%) in hemoglobin A1c between baseline and three-month follow-up, and then identified factors associated with hemoglobin A1c. Participants with diabetes duration less than five years and/or whose diabetes self-efficacy improved between baseline and three-month follow-up were more likely to experience a meaningful decrease in hemoglobin A1c at three months (compared to participants without those characteristics). Next, we will interview S4C participants to further explain the results by asking participants how the factors identified did or did not contribute to their T2D-related behavior change. Finally, we will integrate our mixed methods findings to derive and visually display new insights beyond the information attained separately from the quantitative and qualitative results. These findings will allow DST interventions for Hispanic/Latinx patients with T2D to be more effectively tailored to those most likely to benefit.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases (F32 DK135200)