Given persistent racial/ethnic differences in type 2 diabetes outcomes and the lasting benefits conferred by early glycemic control, we examined racial/ethnic differences in diabetes medication initiation during the year following diagnosis. Among adults newly diagnosed with type 2 diabetes (2005-2016),…
Telemedicine's dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with limited English proficiency. To examine the associations of patient language and patient-provider language concordance with telemedicine visit type (video versus…
Telemedicine use expanded greatly during the COVID-19 pandemic, and broad use of telemedicine is expected to persist beyond the pandemic. More evidence on the efficiency and safety of different telemedicine modalities is needed to inform clinical and policy decisions around…
Telemedicine is increasingly relied upon for care delivery in primary care, but the impact of visit type on clinical ordering behavior is uncertain. Within Kaiser Permanente Northern California, we identified patients who self-scheduled and completed telemedicine encounters with their personal…
Latino adolescents engage in more obesogenic behaviors, including sedentary behaviors and sugary drink consumption, than White adolescents. However, it is unclear whether engagement in obesogenic behaviors differs within the Latino population. Cross-sectional data were examined from Latino adolescents ages 13-17…
Introduction: Telemedicine could increase timely access to primary care-a key dimension of care quality. Methods: Among patient-scheduled appointments with their own primary care providers using the online portal in a large integrated health care delivery system, we measured the association…
Video telehealth can offer people convenient, real-time access to clinicians without arranging transportation or time off work. Among people with diabetes, this study examines the association between video telehealth access and changes in HbA1c. This longitudinal cohort study (2016-2019) used…
The aim of this study is to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. We used multivariate logistic regression to examine the association between the…
Adults with type 2 diabetes diagnosed at a younger age are at increased risk for poor outcomes. We examined life stage-related facilitators and barriers to early self-management among younger adults with newly diagnosed type 2 diabetes. We conducted 6 focus…
Our goal is to evaluate the effectiveness of a proactive, tailored care intervention in improving early outcomes for Latinx individuals with younger-onset type 2 diabetes. We will also conduct post-intervention interviews with study participants to identify components of the intervention…
Cardiovascular disease (CVD) continues to be a leading cause of morbidity in the U.S. Managing CVD risk factors, such as diabetes or hypertension, can be challenging for many individuals. We investigated the barriers experienced by patients who persistently struggled to…
We will evaluate a culturally responsive community health worker (CHW) intervention targeting younger-onset Latinx individuals with a new type 2 diabetes (T2D) diagnosis (AURORA [Active Outreach to Younger Latinx]). The AURORA strategy centers on a CHW who will proactively conduct…
In a population of adults newly diagnosed with type 2 diabetes (T2D) from 2010-2015 and followed for 5 years this study will use machine learning-based predictive analytic methods to develop and validate predictive models using EHR-derived patient data available at…
Social determinants of health (SDoH) influence health outcomes and contribute to disparities in chronic disease in vulnerable populations. To inform health system strategies to address SDoH, we conducted a multi-stakeholder qualitative study to capture the multi-level influences on health for…
Adults diagnosed with type 2 diabetes at a younger age are at increased risk for poor outcomes. Yet, little is known about the early experiences of these individuals, starting with communication of the diagnosis. Addressing this knowledge gap is important…
The primary care visit is an important opportunity to discuss and modify diabetes management. To gain insight into doctor-patient communication during primary care visits among English and Spanish speaking patients with type 2 diabetes and suboptimal glycemic control (HbA1c >…
This study will conduct focus groups with KPNC members (age 45) with newly diagnosed Type 2 diabetes to learn about members’ experiences with this new diagnosis and to identify early facilitators of and barriers to effective diabetes management in this…
The prevalence of type 2 diabetes is increasing among adults under age 45. Onset of type 2 diabetes at a younger age increases an individual's risk for diabetes-related complications. Given the lasting benefits conferred by early glycemic control, we compared…
Patients' understanding of the hemoglobin A1c (HbA1c) has been linked to better diabetes care outcomes (glycemic control, self-care). This is concerning given low documented rates of HbA1c understanding. In this non-blinded, randomized trial, we compared two formats for communicating the…
Among older individuals with type 2 diabetes, those with poor health have greater risk and derive less benefit from tight glycemic control with insulin. To examine whether insulin treatment is used less frequently and discontinued more often among older individuals…
Aim 1: Identify patient-level predictors of metformin treatment during the year following type 2 diabetes diagnosis. Examined factors will include: demographics, such as age, race/ethnicity, gender, and rural versus urban; clinical characteristics, such as A1c at diagnosis, diabetes-related comorbidities (hypertension,…
The HealthyFood (HF) program offers members up to 25% cash back monthly on healthy food purchases. In this randomized controlled trial, we tested the efficacy of financial incentives combined with text messages in increasing healthy food purchases among HF members.…
To examine the prevalence and person-level predictors of undiagnosed Type 2 diabetes among adults with elevated HbA1c values. We identified adults without diabetes who had a first elevated HbA1c (index HbA1c ≥ 48 mmol/mol; ≥ 6.5%) between January 2014 and…
Poor understanding of diabetes management targets is associated with worse disease outcomes. Patients may use different information than providers to assess their diabetes control. In this study, we identify the information patients use to gauge their current level of diabetes…
In a population of adults with newly diagnosed, early onset type 2 diabetes, this study will identify patient-, provider-, and system-level predictors of inadequate glycemic control within one year following diagnosis. A longitudinal, retrospective cohort analysis of electronic health record…
Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency…
Evidence supporting the effectiveness of care management programs for complex patients has been inconclusive. However, past reviews have not focused on complexity primarily defined by multimorbidity and healthcare utilization. We conducted a systematic review of care management interventions targeting the…
Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are…
Aim 1: Describe the type, frequency, and amount of diabetes-related health care KPNC members receive within 1 week, 3 months, and 1 year of a new diabetes diagnosis. Aim 2: Examine the relationships between the type, timing, and amount of…
We compared the effectiveness of diabetes-focused messaging strategies at increasing enrolment in a healthy food programme among adults with diabetes. Vitality is a multifaceted wellness benefit available to members of Discovery Health, a South Africa-based health insurer. One of the…
More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may…
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