1071-P: Association of Race and Ethnicity with Net Promoter Score and Hemoglobin A1c in a Virtual Diabetes Management Program

Virtual solutions to chronic care management including care for diabetes mellitus hold promise for greater convenience, access, and scalability. Better understanding of the association of race and ethnicity on engagement, experience, and outcomes will offer opportunities to optimize health equity. Self-reported race and ethnicity was collected in the Teladoc Virtual Diabetes management program. Bayesian imputation was used to assign race and ethnicity where unreported. Rates of enrollment, net promoter score (NPS), and blood glucose measurements were systematically collected. The Nathan method was used to estimate HbA1c which includes at least 14 blood glucose readings within a 90-day period. Changes in HbA1c were adjusted for baseline. A total of 530,222 participants enrolled were available for analysis with race/ethnicity available in 444,716 (84%) after Bayesian imputation. Of those with available race/ethnicity, 70% were non-Hispanic white, 15% were Hispanic, 10% were black/African American, and 5% were American Indian, Alaskan Native, or Asian Pacific Islander. Overall enrollment was similar across groups. The proportion reporting a positive NPS was numerically higher in patients reporting as Hispanic, Black/African American, or Asian Pacific Islander. Baseline hemoglobin A1C was ~8.5% and similar by Race/Ethnicity. Over a 90-day period, A1C was observed to be lower in all groups and with the greatest numerical change in those reporting as Asian Pacific Islanders followed by Black/African American. In a virtual diabetes management program including 530,222 participants, 70% were non-Hispanic white. Participants had similar rates of enrollment and similar baseline HbA1C measures across reported race/ethnicity. Differences in Net Promoter Score and change in HbA1C were observed by race/ethnicity. These results highlight the importance of considering race/ethnicity in the design and content of virtual programs.