The HOPE App: An Immersive Telehealth Solution for Older Adults with Diabetes

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Project Summary/Abstract: The HOPE APP: An Immersive Telehealth Solution Adapted for Older Adults Type 2 diabetes (T2DM) is an epidemic related to obesity, chronic stress, unhealthy eating and inactivity. An estimated 29 million people in the US have T2DM and 84 million have pre-diabetes - nearly half of whom are adults over 65yo, putting many older adults at higher risk of unhealthy aging and cognitive decline. A healthy lifestyle can treat and even reverse T2DM. But making lifestyle changes is hard and many people fail, contributing to $325 billion in US healthcare costs. Diabetes group visits (DGV) and diabetes self- management education and support (DSME/S) help people with T2DM learn and sustain healthy lifestyle behaviors and master complex disease management skills. Access to DSME/S is limited such that participation in DSME/S programs is as low as 7% of all adults with T2DM. New technologies supporting DSME/S programs are emerging, but most fail to meet the unique needs of older adults with limited technology fluency, creating a new digital divide. The See Yourself Health (SYH) team aims to bridge this digital health gap for older adults with a newly designed immersive learning program – the HOPE APP – designed to deliver diabetes care, DGV, and DSME/S on demand, tailored for older adults with diabetes and accessible on mobile devices commonly used by this age group. Fortunately, new cloud gaming technology and advances in user interface design will enable our team to design a new immersive learning environment tailored for mobile devices to offer DSME/S to meet the needs and capabilities of older adults. HOPE App consists of 28 actionable DSME/S modules and maintenance programming designed for a virtual world using social gaming strategies that emphasize peer support, brain health, and mastery of diabetes self-management skills to allow users to connect with others and simulate new lifestyle behaviors. Phase I Project: We aim to assess the feasibility, acceptability and usability of the newly designed See Yourself Health immersive learning DSME/S solution – the HOPE APP - tailored for older adults with diabetes featuring an adapted human interface for use with mobile device by users with low technology fluency. Specific Aim 1: We will design and build the HOPE APP with educational content, simulation experiences, and a user interface tailored for use by older adults with T2DM. Specific Aim 2: To assess the usability of the HOPE APP using the Rapid Iterative Testing and Evaluation (RITE) method with a total of 20 participants from the target population of adults 65+ with diabetes. Specific Aim 3: To test the feasibility of using the HOPE APP by SYH by older adults on mobile devices. Plan for Phase II: Once we demonstrate the feasibility of delivering the See Yourself Health DSME/S program using a cloud gaming solution, we aim to assess the effects of the platform on cognitive function, physical health, and mental health outcomes in a fully powered clinical trial.