68-OR: Digital Divide and Medicare Diabetes Prevention Program of Beneficiaries with Elevated BMI

The Medicare Diabetes Prevention Program (MDPP) encourages beneficiaries with prediabetes to build healthy lifestyle behaviors that reduce the risk of diabetes. Limited supply of in-person MDPP and telehealth growth, support virtual delivery of MDPP. Success of virtual MDPP is impacted by access to digital devices and the Internet. A survey-weighted multinomial logit model was performed to examine associations between socio-demographics, comorbidities, and computer access and internet usage among beneficiaries. Using the 2020 nationally representative Medicare Current Beneficiary Survey PUF, a three-level categorical dependent variable was created: (1) has a computer AND uses internet, (2) has a computer OR uses internet, and (3) has no access to either (reference group). Of beneficiaries reporting BMI ≥ 25 kg/m² and no diabetes history (n=3,912), 70.6% had a computer AND used internet; 14.2% had a computer OR used internet; and 15.2% lacked a computer and did not use internet. Hispanics, Non-Hispanic Blacks (NHB), and Others were less likely to have a computer AND use internet than non-Hispanic Whites (NHB, OR=0.27; p<0.001). Beneficiaries with lower educational attainment (<high school (HS) and HS) were less likely to have a computer AND use internet (<HS, OR=0.04; p<0.001) or have a computer OR use internet (<HS, OR=0.21; p<0.001) than those with college education. Beneficiaries with lower incomes (<$25,000) were less likely to have a computer AND use internet (OR=0.24; p<0.001) or have a computer OR use internet (OR=0.58; p<0.001) than those with higher incomes. This study found that ~30% of beneficiaries likely eligible for MDPP (potentially representing 6 million beneficiaries) lack digital tools for virtual MDPP. Digital divides by race/ethnicity, income, and education were observed. Efforts to improve access and enrollment in MDPP using virtual delivery must consider digital access to avoid technological disparities among populations with heightened type 2 diabetes risk.