Telemedicine Preparation for Older Adults with Type 2 Diabetes

在新冠肺炎大流行期间，许多初级保健预约被转换为远程医疗。 远程医疗预约对于COVID死亡率高风险的患者可能特别有益， 例如老年人、非裔美国人和2型糖尿病患者。大量研究发现 远程医疗可以成为糖尿病护理的有效场所。不幸的是，这样的干预往往假设 患者已经拥有能够上网的设备、可靠的互联网服务和基本的数字技能。很多病人， 特别是老年患者和非裔美国人，缺乏远程医疗所需的数字技能。不幸的是， 最终的结果是，那些慢性病及其并发症风险最高的人往往最不能 充分利用远程医疗。我们提出了一种数字技能培训干预措施，包括必要的基础知识 参加以非裔美国人为主的老年人(50-70岁)远程医疗预约的技能 护理已经拥有可上网设备但从未使用过互联网的2型糖尿病患者 远程医疗预约。干预的目标是让患者为成功的远程医疗做好准备 预约。患者将首先接受技能评估，然后通过以下方式接受定制的数字技能培训 一个以社区为基础的组织。参与者还将被安排进行虚拟糖尿病管理 在6个月内预约。 对于特定的目标1，我们将测量患者是否转诊到远程医疗培训干预 在6个月内完成远程医疗预约。在具体目标2中，我们将采访患者并 分析面试记录以评估他们在远程医疗方面的经验。成功的患者 完成远程医疗预约将被问及他们对远程医疗培训的满意度 干预和远程医疗预约。参加远程医疗培训干预的患者 但未完成远程医疗预约和/或未完成远程医疗培训将 被问及他们的障碍以及远程医疗培训干预如何更好地满足他们的需求。

During the COVID-19 pandemic, many primary care appointments were converted to telemedicine. Telemedicine appointments may be especially beneficial for patients who are at high risk for COVID mortality, such as older adults, African Americans, and patients with type 2 diabetes. Numerous studies have found telemedicine can be an effective venue for diabetes care. Unfortunately, such interventions often assume that patients already have internet-capable devices, reliable internet service, and basic digital skills. Many patients, especially older patients and African Americans, lack the digital skills needed for telemedicine. Unfortunately, the net result is that those at highest risk for chronic diseases and their complications are often least able to take advantage of telemedicine. We propose a digital skills training intervention comprising essential basic skills to participate in a telemedicine appointment for older (age 50-70 years) mostly African American primary care patients with type 2 diabetes who already own an internet-capable device but have never had a telemedicine appointment. The intervention's goal is to prepare patients to have a successful telemedicine appointment. Patients will first be assessed for skills and then receive customized digital skills training through a community-based organization. Participants will also be scheduled to have a virtual diabetes management appointment within 6 months. For Specific Aim # 1, we will measure whether or not patients referred to the telemedicine training intervention complete a telemedicine appointment within 6 months. In Specific Aim # 2, we will interview patients and analyze interview transcripts to assess their experience with telemedicine. Patients who successfully completed a telemedicine appointment will be asked about their satisfaction with both the telemedicine training intervention and their telemedicine appointment. Patients who enrolled in the telemedicine training intervention but either did not complete a telemedicine appointment and/or did not complete telemedicine training will be asked about their barriers and how the telemedicine training intervention could better meet their needs.