Digital access key to boosting diabetes self-management education uptake for older adults
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Key takeaways:
- Of Medicare beneficiaries with diabetes, 38.6% do not have access to a computer or use the internet.
- Providers should refer older adults with diabetes to organizations that can help provide digital access.
More than one-third of older adults with diabetes lack the digital tools necessary for virtual diabetes self-management education, and providers can play a role in promoting digital inclusion, according to a speaker.
A study published in The Journal of Rural Health in 2022 found 47% of Medicare beneficiaries with type 2 diabetes have participated in diabetes self-management education at any point in their life, with that percentage dropping to 40% for adults living in rural areas. Boon Peng Ng, PhD, associate professor in the department of population health sciences at the University of Central Florida (UCF) College of Nursing and a member of the UCF Disability, Aging and Technology Faculty Research Cluster, said the increased use of telehealth offers a new medium for older adults with diabetes to receive diabetes self-management training. However, findings presented at the Association of Diabetes Care and Education Specialists annual meeting showed more than one-third of Medicare beneficiaries do not have access to a computer, laptop or tablet and do not use the internet, preventing them from easily accessing virtual health care services.
“Health care providers can assist beneficiaries who have difficulty accessing in-person diabetes self-management training or who experience a digital divide,” Ng told Healio. “Screening for diabetes self-management training use and access to digital resources can be done during routine examinations. Referrals can then be made to in-person or virtual diabetes self-management training, and to public and private organizations with low-cost technology options.”
Ng and colleagues analyzed data from 1,779 Medicare beneficiaries aged 65 years and older with diabetes and no prior diabetes self-management training. Data were collected from the 2021 Medicare Current Beneficiaries Survey Public Use File.
Of the study group, 38.6% did not have a computer, laptop or tablet and did not use the internet. In survey-weighted multivariable logistic regression analysis, adults aged 75 years or older were less likely to have computer and internet access than adults aged 65 to 74 years (marginal effect, –11.3%; 95% CI, –15.8 to –6.7). Men were less likely to have access to digital tools than women (marginal effect, –4.3%; 95% CI, –7.8 to –0.7) and adults living outside a metropolitan area were less likely to own a computer, laptop or tablet and use the internet than adults living in a metropolitan area (marginal effect, –5.9%; 95% CI, –11.3 to –0.5).
Non-Hispanic Black adults (marginal effect, –13.5%; 95% CI, –22.1 to –4.8). and Hispanic adults (marginal effect, –21.7%; 95% CI, –30 to –13.4) were less likely to have a computer and internet access than non-Hispanic white adults. Access to digital tools was less likely for adults with an average annual income of less than $25,000 than for those with an income of $25,000 or higher per year (marginal effect, –15.3%; 95% CI, –21.8 to –8.8). Adults without a high school education were less likely to own a computer and have internet access than adults with a high school education (marginal effect, –24%; 95% CI, –29.8 to –18.3) and those with greater than a high school education (marginal effect, –54.5%; 95% CI, –62.9 to –46.1).
“Unfortunately, many of these factors are linked to the social determinants of health or nonmodifiable personal characteristics, therefore accessing the program can be challenging for many,” Ng told Healio.
In order to improve diabetes self-management training uptake for older adults, Ng said providers must be creative and find ways to improve access to digital tools.
“To reduce these disparities, particularly for older adults, we should focus on accessibility, affordability, acceptability and technology literacy,” Ng said during the presentation. “There are public and private organizations ... who have a lot of technology literacy-related training and some of them even have low-cost technology options available.”
Reference:
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Ng BP, et al. Abstract F09B. Presented at: ADCES24; Aug, 9-12, 2024; New Orleans.
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