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

项目摘要 2型糖尿病(T2 DM)是一种流行病。据估计，美国有3400万人患有2型糖尿病 8400万人患有糖尿病前期，其中近一半是65岁以上的成年人，这让许多人年龄更大 成年人有更高的不健康老龄化和认知能力下降的风险。健康的生活方式可以治疗和 甚至逆转T2 DM。但改变生活方式很难，许多人都失败了，这对 美国医疗保健成本为3270亿美元。糖尿病团体访视与糖尿病自我管理 教育和支持(DSME/S)帮助T2 DM患者学习和支持复杂疾病 管理技能。然而，接触DSME/S的机会是有限的，例如参与DSME/S方案 据报道，在成年T2 DM患者中，这一比例低至7%。支持DSME的新技术/S 项目正在涌现，但大多数项目未能满足老年人的独特需求， 技术的流畅性，造成了新的数字鸿沟。See Your Health(SYH)旨在弥合这一点 通过新设计的沉浸式学习和远程医疗，为老年人提供数字健康差距 应用程序-希望应用程序-旨在提供高影响、高参与度的糖尿病护理 和DSME/S为患有糖尿病的老年人量身定做。 虚拟现实软件、新的云游戏技术和用户界面的进步 设计使我们的团队能够设想一种新的远程健康和沉浸式学习环境 支持老年糖尿病患者的慢性病自我管理需求。我们使用虚拟 提供实时对等的现实、电信技术和社交游戏策略 支持、关怀指导和28个现场体验学习计划模块，以帮助 参与者掌握复杂的糖尿病自我管理技能。在我们的第一阶段SBIR项目中，我们 达到了以下里程碑：制作了具有云访问和 新的导航和通信功能；已完成可用性测试(SUS=71)，20 希望App平台的目标用户和可行性测试(100%参与)；开发 针对老年人的新DSME内容。在第二阶段，我们将进一步开发HOPE App Patient 参与度和人口健康管理特点和能力，然后评估其 在全功率临床试验中的疗效。 具体目标1：开发希望应用程序最先进的沉浸式患者参与 自动化入职、社交网络和游戏化DSME/S功能的经验 支持长期留住病人。 具体目标2：开发希望应用程序对人口健康的预测分析能力 管理层。 具体目标3：HOPE App干预对6个月临床结果的临床验证 (A1C)，患者报告的结果(糖尿病痛苦)和敬业度(患者保留， 坚持DSME/S)。SYH组建了一支专家业务团队，将HOPE应用程序销售给 我们的目标客户，医疗保健支付者。 Hope应用程序提供简单、高影响力、极具吸引力、身临其境的远程医疗体验 有可能成为一种无处不在的糖尿病管理工具，以改变糖尿病 将患者转化为自己护理的高绩效司机。

Project Abstract Type 2 diabetes (T2DM) is an epidemic. An estimated 34 million people in the US have T2DM and 84 million have pre-diabetes - nearly half of whom are adults 65+ yo, 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 $327B in US healthcare costs. Diabetes group visits (DGV) and diabetes self- management education and support (DSME/S) help people with T2DM to learn and sustain complex disease management skills. Yet, access to DSME/S is limited such participation in DSME/S programs is reportedly as low as 7% among 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. See Yourself Health (SYH) aims to bridge this digital health gap for older adults with a newly designed immersive learning and telehealth application – the HOPE App – designed to deliver high-impact, high engagement diabetes care and DSME/S tailored for older adults with diabetes. Advancements in virtual reality software, new cloud gaming technology and user interface design have enabled our team to envision a new telehealth and immersive learning environment to support chronic disease self-management needs of older adults with diabetes. We use virtual reality, telecommunication technology and social gaming strategies to offer real-time peer support, care coaching, and 28 modules of live-action experiential learning programs to help participants master complex diabetes self-management skills. In our Phase I SBIR project, we reached the following milestones: prototyped the HOPE App platform with cloud access and new navigation and communication features; completed usability testing (SUS = 71) with 20 target users and feasibility testing (100% participation) of the HOPE App platform; developed new DSME content for older adults. In Phase II, we will further develop the HOPE App patient engagement and population health management features and capabilities and then assess its efficacy in a fully powered clinical trial. Specific Aim 1: Develop the HOPE App’s state-of-the-art immersive patient engagement experience with automated onboarding, social networking and gamified DSME/S features to support long-term patient retention. Specific Aim 2: Develop the HOPE App’s predictive analytic capabilities for population health management. Specific Aim 3: Clinical validation of the HOPE App intervention on six-month clinical outcomes (A1c), patient reported outcomes (diabetes distress) and engagement (patient retention, adherence to DSME/S). SYH has assembled an expert business team to sell the HOPE APP to our target customer, health care payors. The HOPE APP offers a simple, high impact, highly engaging, immersive telehealth experience with the potential to become a ubiquitous diabetes management tool to transform diabetes patients into high performing drivers of their own care.