Pack Health recently presented findings at the National Association of Community Health Centers (NACHC) Community Health Institute (CHI) and EXPO: CHI@Home for the poster entitled, Using Digital Health Coaches to Reach and Impact African Americans with Type 2 Diabetes: A Real-World Study.

An estimated 32.6 million Americans have type 2 diabetes (T2DM), and African Americans are at particularly high risk, with 12.1% of the population diagnosed[1, 2]. Diabetes self-management support services can help disparately impacted individuals sustain the positive coping skills and behaviors needed to manage diabetes on an ongoing basis outside of formal self-management training [3]. Digital health coaching is an increasingly common support strategy designed to meet the individual needs of patients in an accessible and affordable format, and research indicates a subsequent impact on psychosocial, behavioral, and health outcomes [4]. However, despite the need, research is lacking on the specific use and impact of digital diabetes support for African Americans.

Aim and Results

This real-world study aims to explore the feasibility and impact of a digital support program to complement clinic-based services for African American populations.

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 (p<0.0001 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.

Findings and Discussion

Findings suggest that digital health coaching could be a feasible approach to engage and positively impact African American individuals with T2DM. African American participants were highly engaged via phone and text, and retention was high. Statistically, a significant impact was observed across all areas of investigation, with the highest percent change observed for diabetes distress and medication adherence. While the average reduction in HbA1c was significant, baseline HbA1c was notably low. 

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, to what extent it may impact individuals with poor baseline glycemic control, and how Health Advisors can most effectively coordinate with clinics.

For a detailed explanation of the poster, check out the full, virtual presentation by lead author Jonathan Patterson here.