Advancing DSME/S and COVID-19 Prevention and Protection Through "emPOWERed to Change" Program

Several studies have shown that COVID-19 patients with co-existing diabetes were more likely to develop severe or critical disease conditions with more complications, and had higher incidence rates of antibiotic therapy, non-invasive and invasive mechanical ventilation, and death. Another important finding is that African Americans (AA)/People of Color (POC) are disproportionately impacted by COVID-19 to an extent not observed in other racial/ethnic subgroups. Diabetes Self-Management Education and Support (DSMS/S) facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. Now, given the implications of COVID-19 on the AA/POC diabetes community, it is imperative to enhance DSME/S with education about protection and prevention of COVID-19. We will adapt and implement the "emPOWERed to Change" DSME/S program to provide enhanced type 2 diabetes mellitus (T2DM) education with an additional emphasis on COVID-19 protection and prevention. The proposed hypothesis, based on the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), is: African Americans (AA)/People of Color (POC) in Los Angeles County with type 2 diabetes mellitus (T2DM) randomized to participate in the "emPOWERed to Change" program (N=48) are more likely to demonstrate sustained glycemic control, increase in knowledge and skills related behaviors, and risk factors associated with T2DM and SARS-CoV-2 (COVID-19) and increased compliance with prevention, and vaccination as compared to those who are randomized to usual care (N=48) in this 12 week program.

Aim 1: to determine the efficacy of the "emPOWERed to Change" program on the knowledge and skills related to eating habits, physical activity, stress management, and medication adherence in the AA/POC population with type 2 diabetes.

Hypothesis: we hypothesized that AA/POC participants randomized to the program will have 20% increased knowledge and skills related to eating habits, physical activity, stress management, medication adherence, and control of diabetes compared to those randomized to the usual care.

Aim 2 to determine the effect of the "emPOWERed to Change" program on the knowledge related to T2DM and COVID-19 (risk factors, prevention of infection, COVID-19 vaccines, and access resources for vaccination) and compliance with prevention and vaccination against COVID-19.

Hypothesis: we hypothesized that AA/POC participants randomized to the program will have 20% increase in knowledge related to T2DM and COVID-19, compliance with prevention and vaccination against COVID-19 compared to those randomized to the usual care.