Toward Technology Adoption: Extending Telemedicine to Latino Patients with Type II Diabetes

Brigham And Women'S Hospital, Boston MA

Investigators

Linked publications & trials

Abstract

Project Abstract Type II diabetes mellitus affects U.S. adults at varying rates across population groups. For example, individuals who identify as Latino have an age-adjusted incidence rate of 9.7 per 1,000 persons. Among those diagnosed, glycemic control and diabetes-related complications vary widely across subgroups. These patterns in health outcomes are driven by multiple interrelated contextual living conditions and access to healthcare resources. In particular, a lack of access to consistent care and difficulty navigating the healthcare system are critical drivers of these trends. By extending care beyond the clinic, telemedicine presents an opportunity to address these challenges. Telemedicine offers patients video and telephone visits from remote settings. However, current implementation strategies have created significant differences in telemedicine access and use among Latinos. The goal of this K23 is to address this important research gap by evaluating how a tailored implementation strategy can increase telemedicine use by patients with diabetes. My central hypothesis is that by applying a human-centered design approach supported by implementation science, we can improve telemedicine use, an important part of improving diabetes care. The proposed project will test the central hypothesis with the following 3 specific aims. Aim 1 will evaluate existing electronic health record data, telemedicine platforms, and workflows to identify multilevel contributors to telemedicine use patterns among Latino patients with diabetes. Aim 2 will engage participants and health system collaborators to develop a multilevel, tailored intervention targeted at patients and clinicians to promote telemedicine use in the care of Latino patients with diabetes. Aim 3 will conduct a pilot randomized controlled trial of the multilevel, tailored intervention among patients with diabetes and their clinicians. Through an innovative application of human-centered design and implementation science, this proposal addresses overlapping health information technology and variation in diabetes care outcomes among Latino patients with diabetes. The proposed research is complemented by a rigorous training plan and a highly experienced mentorship team that will ensure my transition to independence. The training plan focuses on mixed-effect logistic regression, implementation science, human-centered design, and trial design. This grant will serve as the foundation for a future R01 application evaluating the intervention’s impact on clinical outcomes.