565-P: Baseline Findings from the Dulce Digital 2.0 Trial—Innovative Diabetes Self-Management in the Digital Age

Introduction: Telehealth delivery of diabetes self-management education and support (DSMES) has been widely adopted, yet lower participation is occurring in Hispanics who are disproportionately impacted by type 2 diabetes (T2D). Objective: Describe baseline and recruitment characteristics in an in-progress 3-way RCT that will compare the effectiveness of the Dulce Digital text messaging program and live in-person and virtual delivery (video telehealth classes) of Project Dulce DSMES in improving glycemic management of 150 Hispanic adults with T2D and A1C of ≥ 8%.

Methods: Descriptives statistics.

Results: There were 612 patients approached after EHR review. After recruitment screening, 69% did not meet the eligibility criteria, 8% were eligible and interested, and 24% were eligible but not interested. Reasons for disinterest were inconvenient class times (48%), concerns about study demands (e.g., length of study; 23%), distrust in research or health professionals (20%), lack of access to study location (6%), and limited access/knowledge of technology (2%). Enrolled participants (n=46) were on average 55 ± 11.3 years old, and 50% were female, 44% were born in the US, 70% had English as the preferred language, 54% were employed full-time, 49% had ≤ high school education, and 38% had an annual household income of ≥ $55K. Mean baseline A1C was 9.5% ± 1.5. Mean scores for Summary of Diabetes Self-Care Activities subscales were diet = 3.8 ± 1.9, exercise = 3.2 ± 2.4, glucose management = 3.8±2.6, and foot care = 3.5 ± 2.5 (range = 0-7); and Brief Measure of Healthy Literacy scale was 2.4 ± 1.5 (range = 0-10).

Conclusion: The average baseline A1C was high while mean scores for self-care behaviors were low-to-moderate and low for health literacy. Healthcare systems should consider addressing multilevel barriers to in-person and telehealth DSMES delivery to enhance engagement and improve diabetes outcomes, especially in high-risk Hispanic adults with limited health literacy.