473-P: Feasibility and Acceptability of a Direct-to-Home Diabetes Self-Management Education and Support Telemedicine Program (DSMES) with High-Risk Patients in a Rural, Underserved Area

Ongoing support is critical to DSMES effectiveness, but difficult to realize, particularly in underserved areas with limited resources. The purpose of this study, initiated February 2020, was to evaluate the feasibility and acceptability of Telemedicine for Reach, Education, Access, Treatment, and Ongoing Support (TREAT-ON), a DSMES model delivered primarily through direct-to-home videoconferencing. Methods: High risk patients with diabetes (A1c >9% or unplanned care) from rural federally qualified health centers were referred to TREAT-ON. Participants completed an initial face-to-face or virtual visit with a Diabetes Care and Education Specialist (DCES) to assess needs and develop self-management treatment plan and behavioral goals. Planned follow-up visits, used to support achieving and sustaining goals and outcomes, were conducted through videoconferencing. To assess feasibility and acceptability over first 3-months of participation, visit frequency, duration, completion rates, and technology issues were tracked and patients completed the Telehealth Usability Questionnaire (TUQ). Results: Participants (n=25) were 60% female, 92% White, mean age 47.6±13.6y, mean A1c 11.5±1.8% and 76% had Medicare or Medicaid. They participated in 3 video visits, on average, lasting a mean of 35 minutes/visit. Of all scheduled video visits (n=99), 71% were successfully completed and 23% had technology issues (difficulty setting up system, connectivity issues). The TUQ revealed that participants were highly satisfied with the TREAT-ON videoconferencing approach (4.7/5), finding it useful (4.5/5), easy to learn/use (4.5/5), reliable (4.3/5), with quality interface (4.6/5) and interaction (4.7/5). Conclusion: This telehealth DSMES model offers a promising approach to improve opportunities for ongoing support to vulnerable individuals in underserved communities. Disclosure J. S. Krall: Research Support; Self; Becton, Dickinson and Company, Sanofi. J. Ng: Research Support; Self; Sanofi-Aventis. P. A. Johnson: None. S. L. Reynolds: None. L. M. Siminerio: Advisory Panel; Self; Abbott Diabetes, Bayer U. S., Research Support; Self; Becton, Dickinson and Company. Funding National Institute of Diabetes And Digestive and Kidney Diseases (R34DK123370)