CP20 - Using Digital Health Coaches to Reach and Impact African Americans with Type 2 Diabetes: A Real-World Study

Poster Type: Research

Category: Expanding Access to Care and Other Services

Research Objectives: African Americans are disparately impacted by Type 2 Diabetes (T2DM). Diabetes self-management support services can help disparately impacted individuals sustain positive coping skills and behaviors. This real-world retrospective study aims to explore the feasibility and impact of a virtual support program to complement clinic-based services for African American populations.

Study Design/Methods: African Americans with T2DM enrolled in a 12-week digital health coaching program including phone, email and text communications with a Health Advisor. Advisors facilitated goal setting, addressed self-management barriers and provided care coordination as needed. Feasibility was assessed using engagement metrics (retention, frequency, call length). A retrospective analysis assessed changes in self-reported HbA1c and Patient Reported Outcomes (PROs) from baseline to 12-week follow-up. PROs included overall physical and mental health, medication adherence, health self-efficacy and diabetes distress evaluated using validated instruments (PROMIS Global 10, CASE, HSE, DDS2). Descriptive statistics and paired t-tests were used to calculate frequency changes and significance.

Principal Findings and Quantitative/Qualitative Results: To date, 415 African Americans enrolled, of which 277 (67%) were retained. On average, participants received 13.75 calls and 43.1 text messages, yielding an average engagement of 252 minutes with 14.16 minutes spent per call. There were improvements in HbA1c, physical and mental health, medication adherence, health self-efficacy and diabetes distress (pxtagstartz0.0001 across all metrics). HbA1c decreased by 0.54% (pre: 7.74 – post: 7.2%). PROMIS physical and mental health scores increased by 3.3 (pre: 44.59 – post: 47.89) and 3.26 (pre: 48.16 – post: 51.42) respectively.

Conclusions on Impact on Health Centers: Findings suggest that digital health coaching could be a feasible approach to engage and positively impact African American individuals with T2DM. Patient-reported clinical metrics and outcomes demonstrate the potential effectiveness of this approach in improving glycemic control, overall physical and mental health, health self-efficacy and medication adherence. This approach could be used to effectively expand patient access to support services outside of the community health clinic setting, and complement care and education provided within clinics. Additional research is needed to understand how this approach modifies barriers to self-management, and how Health Advisors can most effectively coordinate with clinics.

Author(s):

Jonathan Patterson, MBA, Data Analyst, Research, Pack Health

Megan Martin, MPH, Director, Strategic Partnerships and Programs, Pack Health

Dhiren Patel, PharmD, Vice President, Pack Health

T.R. Wilson, MS, NBC-HWC, Senior Health Advisor, Pack Health

Matt Allison, MS, Director, Research, Pack Health