title: Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team.
abstract: Background. The feasibility of digital health programs to prevent and manage diabetes in low-income patients has not been adequately explored.Methods. Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. We conducted focus groups to assess patient perspectives, revised lessons for improved readability and cultural relevance to low-income and Hispanic patients, conducted a feasibility study of the adapted program in English and Spanish speaking cohorts, and implemented real-time adaptations to the program for commercial use and for a larger trial of in multiple safety net clinics.Results. The majority of focus group participants were receptive to the program. We modified the curriculum to a 5th-grade reading level and adapted content based on patient feedback. In the feasibility study, 54% of eligible contacted patients expressed interest in enrolling (n= 23). Although some participants' computer access and literacy made registration challenging, they were highly satisfied and engaged (80% logged in at least once/week).Conclusions. Underserved prediabetic patients displayed high engagement and satisfaction with a digital diabetes prevention program despite lower digital literacy skills. The collaboration between researchers and a digital health company enabled iterative improvements in technology implementation to address challenges in low-income populations.
authors.affiliation: Division of General Internal Medicine, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA; Center for Vulnerable Populations, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA.
authors.forename: Valy
authors.identifier: 0000-0003-0795-3237
authors.initials: V
authors.lastname: Fontil
authors.affiliation: Omada Health, 500 Sansome St., Suite 200, San Francisco, CA 94111, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: McDermott
authors.affiliation: Division of General Internal Medicine, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA; Center for Vulnerable Populations, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA.
authors.forename: Lina
authors.initials: L
authors.lastname: Tieu
authors.affiliation: Division of General Internal Medicine, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA; Center for Vulnerable Populations, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Rios
authors.affiliation: Omada Health, 500 Sansome St., Suite 200, San Francisco, CA 94111, USA.
authors.forename: Eliza
authors.initials: E
authors.lastname: Gibson
authors.affiliation: Omada Health, 500 Sansome St., Suite 200, San Francisco, CA 94111, USA.
authors.forename: Cynthia Castro
authors.initials: CC
authors.lastname: Sweet
authors.affiliation: Omada Health, 500 Sansome St., Suite 200, San Francisco, CA 94111, USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Payne
authors.affiliation: Division of General Internal Medicine, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA; Center for Vulnerable Populations, University of California, San Francisco (UCSF) at Zuckerberg San Francisco General Hospital and Trauma Center, P.O. Box 1364, San Francisco, CA 94143, USA.
authors.forename: Courtney R
authors.identifier: 0000-0002-1111-8595
authors.initials: CR
authors.lastname: Lyles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011203:Poverty; D015397:Program Evaluation; D055815:Young Adult