Rising third-year medical student Carolina Gonzalez Bravo is the recipient of a research grant from the Infectious Diseases Society of America (IDSA) Foundation. The foundation’s Grants for Emerging Researchers / Clinicians Mentorship (GERM) program is designed to nurture physician-scientist trainees across the country, particularly those from populations underrepresented in medicine. Awardees receive a stipend and guided mentorship in a project focusing on pediatric or adult infectious diseases.

Gonzalez Bravo’s project will focus on addressing disparities of care among people who primarily speak Spanish and among Black and Indigenous People of Color (BIPOC). Specifically, she will focus on preventing and treating diabetes-related skin infections through a combination of patient interventions and medical student education. The patients she will work with are the residents of Storm Lake, Iowa⁠—a rural community in western Iowa that as of the 2020 census identifies as the most ethnically diverse in the state. Gonzalez Bravo will also work with the multicultural health coalition SALUD!, which is part of an active, ongoing collaboration with the University of Iowa Equity in Health Science and Practice initiative (E-HSP).

[Read more about the E-HSP and their work with SALUD! and the residents of Storm Lake.]

“Given the disparity in diabetes rates among Hispanic/Latino adults and the prevalence of cutaneous infections among patients with diabetes,” Gonzalez Bravo said, “it is important to understand how these infections manifest.” These higher incidences can be traced to inequities in access to health care due, in part, to language barriers between patients and providers. In addition to misunderstandings, these barriers can also lead to delays in care.

To address these breakdowns and barriers, Gonzalez Bravo will create a tool for people with diabetes on safe skin care practices, such as safely administering insulin, and warning signs in the event of an infection. These materials will be in the form of a checklist and accessible to Spanish-only speakers as well as individuals with some English fluency. After development, she will incorporate revisions with feedback from the Storm Lake residents and community partners. The tool will be made available to them upon completion at no cost.

The educational module for medical students will teach about common types of skin infections among people with diabetes. “These conditions will be presented in the form of patient cases,” Gonzalez Bravo said. They will include images of Fitzpatrick Skin Types IV, V, and VI and will be translated into Spanish. These will also be distributed for use by Spanish-English medical interpreters. Both sets of materials will be cross-referenced with existing literature and resources and reviewed with the guidance of a faculty mentor.

Gonzalez Bravo is already familiar with that faculty mentor, Martha Carvour, MD, PhD. The two have been working together on the E-HSP project since 2021. That summer, Gonzalez Bravo was one of the UI’s Summer Research Fellows and worked with Carvour on a quantitative analysis of diabetes-related foot ulcers and infections. She joined Carvour’s lab the next year on a full-time research externship fellowship learning a variety of research skills while working on a qualitative study on the same subject.

Carvour said Gonzalez Bravo is a “valued collaborator” to other lab members and a consultant to other labs, who have “taken notice of the skills and methods” she has developed. Carvour cites the “unwavering commitment to advancing health equity through research, community engagement, and advocacy” as evidence of her “excellent” candidacy for the GERM Program. This new project, in particular, Carvour said, “represents a timely and substantive contribution to the field.”