Improving Telehealth Access for Adults with Diabetes and Hypertension Using Digital Coaching and Clinic Support

What this Trial Is About

This research aims to improve telehealth access for low-income adults with chronic health conditions such as diabetes and hypertension by addressing both patient and clinic barriers. It evaluates a multi-level approach that includes digital health coaching for patients and practice facilitation at clinics to promote equitable telehealth use, especially among Black and Latinx populations. The study focuses on improving control of chronic conditions and increasing digital literacy and engagement with health technology. The interventions being studied include patient-level digital health coaching, which offers support in accessing devices, broadband, and telehealth skills, combined with chronic disease coaching. Clinic-level practice facilitation helps primary care teams address disparities in telehealth use by reviewing equity data and involving patient advisory councils. Participants are randomly assigned to one of four groups combining these interventions or usual care, with follow-up at 3, 6, 12, and 24 months to assess effects. Participants will complete clinical assessments such as hemoglobin A1C and blood pressure measurements, and digital engagement will be monitored through patient portal use and telehealth visit rates. Additional measures include medication adherence, digital literacy, and patient activation. The study evaluates both patient and clinic outcomes over two years, with ongoing data collection, observations, and interviews to understand implementation and integration into practice.

Achieving Chronic Care equiTy by leVeraging the Telehealth Ecosystem