Designing with health literacy in mind can help with SDOH, study finds

There is a widespread belief that social determinants of health like income and level of education can negatively impact the use of digital health programs, and that this could widen equity gaps in health. health.

However, a recent study by telemedicine technology and service provider Teladoc Health found that participants successfully controlled their diabetes with a remote diabetes monitoring program despite existing barriers to accessing care.

The results revealed that although assessed SDOH was associated with differences between participants in their baseline glucose levels, these differences disappeared after one year of enrollment in Teladoc Health’s diabetes management program.

Ultimately, SDOH does not appear to impact the use of the remote diabetes monitoring program known to improve A1c by addressing individualized needs through designed education and coaching. to meet health literacy levels, according to the study. In fact, the remote diabetes monitoring program can help solve SDOH by providing individuals with a personalized experience to meet their health literacy needs and access to timely support, according to the study. .

Health Informatics News sat down with Dr. Teja Kompala, director of clinical products at Teladoc Health, to discuss the study and how telemedicine can help with SDOH.

Q. Please describe the remote diabetes monitoring program/social determinants of health study you conducted. Who did you study, what was the nature of SDOH and what were the patients doing in the study?

A. Our study of people with diabetes suggests that when these programs are designed with consideration of an individual’s levels of health literacy, barriers to care they may face, and an understanding of their individualized coaching needs , SDOH does not appear to impede high program engagement, which may improve health and blood glucose measurements.

The study, which was presented at the American Diabetes Association’s 82nd Scientific Session in June 2022, examines the extent to which members’ income level, education level, and area deprivation index have affected use of the Teladoc Health Diabetes Management Program.

Participants completed an electronic study survey within six weeks of study initiation, and program data was used to calculate results for program use and glycemic control within 90 days. investigation.

Participants were people aged 18 to 89 with type 1 or type 2 diabetes and enrolled in Teladoc Health’s diabetes management program for 12 to 18 months. Of the 1,308 respondents, the average age was 51, 54% were female, 13% black, 5% Asian, 12% Hispanic, and 84% living with type 2 diabetes.

Q. What were the results you achieved after one year of patients in the program? And how did SDOH affect the results?

A. Our results revealed that although assessed SDOH was associated with differences between participants in their baseline glucose levels, these differences disappeared after one year of enrollment in the diabetes management program.

After adjusting for participant characteristics, duration of diabetes, and medication use, they had no negative impact on measures of program use or glycemic control.

The study found that a person’s income and education level do not negatively impact program utilization metrics or health outcomes when using our management solution. diabetes. In fact, our findings suggest that programs that address individualized needs can help break down barriers to care.

It is clear, however, that we must continue to consider the individual needs of members in order to provide improved care and outcomes for everyone, everywhere.

Q. How does all of this address the belief by some that certain SDOHs can negatively affect digital health usage?

A. There’s the notion that the social determinants of health can affect access and worsen outcomes, widen disparities, and that tools like this will only make things worse, but our research and results suggest the opposite.

Remote diabetes monitoring programs can help address the social determinants of health by providing individuals with a personalized experience to meet their health literacy needs and access timely support. Overall, these remote monitoring devices expand access to real-time symptom management support, reducing unnecessary healthcare utilization and improving health outcomes.

Q. Did your findings reveal in any way that digital health, in this case the remote diabetes monitoring program, helped SDOH?

A. A huge learning for us is the impact that thoughtful design, presentation and cultural awareness can have on the success of a remote diabetes monitoring program. We have designed a program so that anyone, regardless of their social determinants of health, can be a high user of the program, which we know results in clinical improvement.

Take, for example, health literacy, which is an important component of the success of this program. We found significant differences in levels of health literacy within this population, where some people did not understand their disease and could not diagnose it correctly.

Our program is designed and written in such a way, however, to support these different levels of health literacy, that these individuals have been able to achieve excellent health outcomes after prolonged use of the program. Additionally, cellular-connected devices allow for easy access, and program designs that help remove financial barriers can drive engagement.

We hope to continue research on health literacy and income level to improve program design for increased engagement and outcomes.

Twitter: @SiwickiHealthIT
Email the author: [email protected]
Healthcare IT News is a HIMSS Media publication.

About Shirley L. Kreger

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