Mil Familias-Santa Barbara's Operational Pilot to Understand Diabetes in the Latino Community

Mil Familias Program Pilot will measure genetic influences by a family medical history & biobank blood samples. Biologic influences will include laboratory blood draw, physical exam with vital signs & waist circumference measurement, and complete medical & medication history with female menopause, pregnancy, & gestational diabetes status. Behavior influences will include sleep, stress, drug abuse, and diabetes self-assessment management questionnaires. Wearable devices will measure physical activity. Psychological influences will include Patient Health Questionnaire-9, Brief Perceived Ethnic Discrimination Questionnaire Community Version, and Short Form Health Survey. Social/environmental influences will include socio-demographics, Brief Acculturation Scale for Hispanics, personal opinions about type 2 diabetes, and questionnaires [Short Assessment of Health Literacy, Trust in Physician, Health Leads Screening Toolkit, and U.S. Household Food Security Survey].

Socio-demographics assessed by questionnaire.

Participant report and self-assessment of diabetes management by questionnaire

Food security or insecurity assessed by a six-item short form developed by the Economic Research Service, United States Department of Agriculture (USDA), September 2012

The Health Leads Screening Tookit (Boston, MA) will be used to determine social needs

Number of healthcare visits assessed in medical record review and the difficulty in traveling to the healthcare provider assessed by questionnaire

Questions regarding personal opinions regarding the burden of diabetes on Latinos measured by specific questions

How well a participant is supported in diabetes care measured by a questionnaire from the American Diabetes Association (ADA) Participant Self-Assessment of Diabetes Management questionnaire

Medical history, family medical history, and current medications and medication history assessed by interview and electronic medical records

Menopausal status, pregnancy status, and gestational diabetes history for female participants will be determined by interview and electronic medical records

Physical exam with vital signs and questions about neuropathy, retinopathy, dental, and eye exams

Laboratory blood draw for evaluation of physiological markers related to diabetes

Urine sample collected for measuring microalbumin, creatinine, and the microalbumin/creatinine ratio

The Patient Health Questionnaire (PHQ)-9 is the Major Depressive Disorder (MDD) module of the full PHQ

The purpose of the DAST-20 is to provide a brief, simple, practical, but valid method for identifying individuals who are abusing psychoactive drugs; and to yield a quantitative index score of the degree of problems related to drug use and misuse

Participants wear an ActiGraph and Fitbit activity monitors simultaneously for 1 week

BASH is a participant reported questionnaire to measure acculturation

SAHL is a participant reported questionnaire to measure health literacy

PEDQ-CV is a participant reported questionnaire to measure perceived ethnic discrimination

PSS is a participant reported questionnaire to measure stress

The SF-12 is a participant reported questionnaire to measure quality of life

The OSQ is a participant reported questionnaire to measure sleep quality

The TPS is a questionnaire and scale to determine trust in the physician

A local consortium of partners will be engaged with formal operational partnerships that include signed agreements and statements of work. These partnerships will include local health clinics and providers, the county, Hispanic/Latino community groups, other non-profit groups involved with the Hispanic/Latino community, and health promoters such as the Young Men's Christian Association (YMCA).

Curricula will be developed, delivered, and evaluated by the number of health workers trained & employed and the number of encounters between participants & trained health workers (Especialistas). Three modules of training curriculum will be developed for Type 2 Diabetes (T2D) Educators, Researchers, and Care Navigators. Training includes T2D clinical aspects, health determinants, diabetes education for Latinos, technology integration into diabetes education, focused diabetes education, research fundamentals, Good Clinical Practice, human subjects protections, participant recruitment, selection & enrollment, clinical data collection, qualitative data collection methods, technology to enhance & facilitate diabetes research, health care sequence, diabetes resources, social and health care resources, health insurance coverage & eligibility, making referrals to resources, sociocultural insight to diabetes care navigation, and technology facilitate access to resources.