553-P: Digital Storytelling Intervention for Type 2 Diabetes Self-Management among Hispanic Adults—A Randomized Clinical Trial

Background: Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research (CBPR) approach to surface the voices of participants overcoming obstacles to healthful behaviors that perpetuate health inequities. A digital storytelling intervention for type 2 diabetes (T2D) self-management was developed by a CBPR partnership. Assessment in primary care settings demonstrated feasibility and acceptability of the intervention. This study assessed the intervention impact on glycemic control among Hispanic patients with poorly controlled T2D.

Methods: A randomized controlled trial was conducted at two primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A1c≥8%). Patients were randomly assigned to receive the intervention by viewing the video at the clinical facility plus access to the intervention on a software application or to no intervention. Both groups received usual diabetes care. The 12-minute intervention included an introduction, four stories with transitions, and a closing educational message re-enforcing diabetes self-management goals. The primary outcome was the mean change from baseline of hemoglobin A1c at 3 months. Secondary outcomes included blood pressure, LDL cholesterol, body mass index, and self-reported diabetes self-management behaviors.

Results: There was a small improvement in hemoglobin A1c in the intervention group compared with the control group after adjusting for baseline A1c, age, sex, education, and income (9% to 8.3% in the intervention group compared with 9.4% to 8.8% in the control group, p=0.04). There were no statistically significant changes in secondary outcomes.

Conclusion: A digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control.