Adapting a home telemonitoring intervention for underserved Hispanic/Latino patients with type 2 diabetes: an acceptabil
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(2020) 20:324
RESEARCH ARTICLE
Open Access
Adapting a home telemonitoring intervention for underserved Hispanic/Latino patients with type 2 diabetes: an acceptability and feasibility study Renee Pekmezaris1,2,3,4*, Myia S. Williams1,3,4, Briana Pascarelli1,3,4, Kayla D. Finuf1,3,4* , Yael T. Harris2,5, Alyson K. Myers2,3,4,5, Tonya Taylor6, Myriam Kline3, Vidhi H. Patel1,3,4, Lawrence M. Murray7, Samy I. McFarlane8, Karalyn Pappas3, Martin L. Lesser2,3, Amgad N. Makaryus2,9, Sabrina Martinez4, Andrjez Kozikowski1,2,3,4, Jennifer Polo10, Josephine Guzman10, Roman Zeltser2,11, Jose Marino4, Maria Pena11,12, Ralph J. DiClemente13 and Dilcia Granville14
Abstract Background: Home telemonitoring is a promising approach to optimizing outcomes for patients with Type 2 Diabetes; however, this care strategy has not been adapted for use with understudied and underserved Hispanic/Latinos (H/L) patients with Type 2 Diabetes. Methods: A formative, Community-Based Participatory Research approach was used to adapt a home telemonitoring intervention to facilitate acceptability and feasibility for vulnerable H/L patients. Utilizing the ADAPT-ITT framework, key stakeholders were engaged over an 8-month iterative process using a combination of strategies, including focus groups and structured interviews. Nine Community Advisory Board, Patient Advisory, and Provider Panel Committee focus group discussions were conducted, in English and Spanish, to garner stakeholder input before intervention implementation. Focus groups and structured interviews were also conducted with 12 patients enrolled in a 1-month pilot study, to obtain feedback from patients in the home to further adapt the intervention. Focus groups and structured interviews were approximately 2 hours and 30 min, respectively. All focus groups and structured interviews were audio-recorded and professionally transcribed. Structural coding was used to mark responses to topical questions in the moderator and interview guides. Results: Two major themes emerged from qualitative analyses of Community Advisory Board/subcommittee focus group data. The first major theme involved intervention components to maximize acceptance/usability. Subthemes included tablet screens (e.g., privacy/identity concerns; enlarging font sizes; lighter tablet to facilitate portability); cultural incongruence (e.g., language translation/literacy, foods, actors “who look like me”); nursing staff (e.g., ensuring accessibility; appointment flexibility); and, educational videos (e.g., the importance of information repetition). A second major theme involved suggested changes to the randomized control trial study structure to maximize
*Correspondence: [email protected]; [email protected] 3 Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA Full list of author information is available at the end of the article © The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, d
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