(P119) Rural-D1D: A Hybrid Telehealth Intervention to Reach Multiple Rural Primary Care Practices and Patients

Key Takeaways of Your Research: A hybrid telehealth DSMES intervention simultaneously delivered to multiple rural primary care practices and patients in their home is feasible and acceptable. Using a hybrid telehealth approach to deliver DSMES shares resources across multiple primary practices. Providing patients with the ability to choose how to receive telehealth DSMES (in the home or primary care practice where they receive care) increases reach to people with diabetes across geographically sparse rural areas.

Background/Purpose: Diabetes self-management education and support (DSMES) equips people with the knowledge and skills necessary to manage diabetes. Individuals in rural areas have decreased access to DSMES, especially DSMES that is culturally tailored to the rural context. Given the population density is sparse across large rural areas, interventions that can deliver group DSMES across a large geographic space are needed. Research Hypothesis and/or Research Questions and Specific

Aims: We developed the Rural Diabetes One Day (R-D1D) program, a multidisciplinary 5.5-hour DSMES intervention in English and Spanish that is culturally tailored to the rural context. This study was to explore the feasibility of delivering R-D1D to multiple rural primary care practices and patients at home simultaneously using telehealth. Methods/Methodology: An implementation science framework was used to deliver four R-D1D interventions using an iterative process. R-D1D was delivered by a Utah-based DSMES telehealth team (nurse practitioner/physician, dietitian, social worker, and pharmacist) to rural Colorado. Primary care practice patients were given the choice to receive R-D1D in their home or at the clinic where they receive care.

Results: Patients (N=34; 70.6% female, 92.2% type 2 diabetes, 52.9% Hispanic/Latino) participated in one of the following R-D1D groups. Group 1 was delivered in Spanish to one practice. Group 2 was delivered in English simultaneously to one practice and two participants in the home. Group 3 was delivered in Spanish simultaneously to two practices. Group 4 delivered in English simultaneously to two practices and one participant in the home and used a breakout session for two 30-minute sessions to split up the practices. Patients who received the intervention in their home reported these reasons: decreased mobility due to a recent surgery, COVID-19 infection, and other personal preferences. Conclusions (Impact on Diabetes Care and Education): Using an iterative approach we found that hybrid telehealth to deliver DSMES to rural Colorado was feasible and acceptable. Patient choice on where to receive DSMES (home or primary care practice) can increase reach as it addresses personal preferences as well as needs related to transportation, childcare, and internet access. Source of Funding for this Research: National Institute of Nursing Research 1R56NR019466-01. Authors: Michelle L. Litchman, PhD, FNP-BC, University of Utah College of Nursing, Salt Lake City, UT, 11.0pt; font-family: 'Arial',sans-serif;">Juliana Simonetti, MD, University of Utah, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, Eli Iacob, PhD, University of Utah College of Nursing, Salt Lake City, UT, Gwen Latendresse, PhD, CNM, University of Utah College of Nursing, Salt Lake City, UT, Julie Neuberger, BS, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, Kristin Curcija, MPH, University of Colorado, Department of Family Medicine, School of Medicine, Aurora, CO, Bethany Kwan, PhD, MSPH, University of Colorado, Department of Emergency Medicine, School of Medicine, Aurora, CO, Sindy Gonzalez, MPH, University of Colorado, Department of Family Medicine, School of Medicine, Aurora, CO, Linda Zittleman, MSPH, University of Colorado, Department of Family Medicine, School of Medicine, Aurora, CO, Tamara K. Oser, MD, University of Colorado, Department of Family Medicine, School of Medicine, Aurora, CO.