The Research Project

One of the primary goals of Nguyen’s research project will be to determine the psychosocial phenotypes that inform how effective a given prediabetes treatment is for a given person. Psychosocial phenotyping is the method by which researchers identify patterns of measurable behaviors, psychological characteristics, and social factors that help explain the variation in people’s ability to self-manage chronic conditions.

“For example, if somebody doesn’t have the capacity or resources to fully engage in certain parts of the DPP, that circumstance could be associated with certain outcomes,” Nguyen said. “Identifying phenotypes like that could help us determine if a particular person should start medication, the program, or both.”

To reach diverse populations of Vietnamese Americans, Nguyen will partner with QARI, which has deep ties with local communities. “We will help Dr. Nguyen manage the community outreach and identify the Vietnamese American groups in several states who can take part in the research project,” said Philip Chong, QARI’s president and CEO. “We’ll help her find the focus groups and get her the right data to eventually create a pilot that is culturally sensitive, creative, and life-changing.”

QARI will also help Nguyen by offering study participants essential social services—workforce development, mental health care, supplemental nutrition—that may make prediabetics more likely to respond well to treatment. For his part, Chong believes the project could help fill a crucial gap in the services QARI already offers.

“When Dr. Nguyen approached me about this grant, I was excited to see a more culturally sensitive approach to such an important issue,” he said. “We know that offering people rewards for changing their lifestyle that week is unlikely to motivate long-term change. What we need are stronger methods and more success stories.”

Because there is uncertainty about which interventions will prove effective, Nguyen will be conducting an adaptive study. That means she will be able to make changes to the trial design based on emerging evidence without jeopardizing the validity of the final results.

“We thought, Why not take a look at a particular decision point to see if it’s working for people or not?” she explained. “If it’s not, how might we take additional resources, support, or social services to get better outcomes?”

While Nguyen hopes that this project will provide the support some Vietnamese Americans with prediabetes need to change their lifestyles, she emphasized that systemic changes will also be necessary to address the diabetes crisis.

“Since healthy living takes a village, we have to address the social determinants of health,” she said. “During the pandemic, many Vietnamese Americans lost access to fresh food while for many reasons, mental health problems skyrocketed. These are not separate concerns: mental health and stress have a negative effect on diabetes and cardiovascular disease.”

Although this project is based around treating the unique needs of different Vietnamese American communities, Nguyen believes that the research could help improve care for all prediabetics.

“If we do our homework and get this right, the principles informing our culturally specific care can be applied to other populations as well,” she said. “This project is one way to think about how to restructure the system to make it easier for people to make healthy changes. Instead of just asking individuals to change their behaviors, however, we always need to start by listening to each community.” ▪

Closing the Gap Closing the Gap

Among Nguyen’s team of collaborators is her advisee May Tadano ’23, a nursing student from New Jersey. “I’m interested in public health nursing,” Tadano said, “so when Dr. Nguyen got the grant, I helped her do an overview of the existing literature.”

Her most important finding? The profound gaps in the research. “Almost none of the studies of Asian Americans included subanalyses based on age, gender, income, education level, and acculturation status,” she said. “That’s what Dr. Nguyen’s project is designed to fix.”

Tadano says she feels lucky to be taking part in the project. “Working with Tam has been a really great experience. I’m grateful that the nursing school integrates research into the curriculum.”