Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Medicine, Division of Endocrinology, North Shore University Hospital, Northwell Health, Manhasset, NY, USA.
Ethn Health. 2020 May;25(4):485-494. doi: 10.1080/13557858.2019.1566520. Epub 2019 Jan 15.
Type 2 Diabetes Mellitus and its complications disproportionately affect non-Hispanic blacks and Hispanic/Latinos more than non-Hispanic whites. These disparities stem from complex interactions between biological, behavioral and socioeconomic factors. In recent years, telemedicine has been used to manage Type 2 Diabetes; however limited recruitment and retention of black and Hispanic/Latino patients into clinical trials exploring the use of telemedicine have necessitated the elucidation of their perceptions regarding participation in such trials. This study investigated patient-reported reasons for declining participation, prematurely terminating participation or demonstrating poor adherence to the study protocol in an ongoing randomized clinical trial, 'Feasibility of Telehealth Management of Diabetes Mellitus type 2 (T2DM) in Black and Hispanic Minority Patients'. Semi-structured interviews comprised of open-ended questions and prompts were conducted by telephone to gauge patients' actual and perceived challenges to participating in the trial and using telemedicine to manage their diabetes. Data were collated with that of the original clinical trial and subsequently content analyzed for overarching themes and trends. Eight semi-structured interviews were completed telephonically. Themes that emerged from analysis included disinterest (47%), inconvenience (33%), lack of perceived benefit (13%), lack of awareness of diabetes diagnosis (7%) and perceived lack of ability to fully participate in the study (7%). Adoption of telemedicine to help minority patients manage diabetes holds promise but is limited by patient factors such as disinterest, inconvenience and lack of perceived benefit. Greater awareness and understanding of these issues will be critical as we strive for greater health equity in disparity patients with uncontrolled diabetes.
2 型糖尿病及其并发症不成比例地影响非西班牙裔黑人和西班牙裔/拉丁裔，比非西班牙裔白人更为严重。这些差异源于生物学、行为和社会经济因素之间的复杂相互作用。近年来，远程医疗已被用于管理 2 型糖尿病；然而，由于在探索远程医疗使用的临床试验中，招募和保留黑人和西班牙裔/拉丁裔患者的数量有限，因此有必要阐明他们对参与此类试验的看法。本研究调查了患者报告的拒绝参与、提前终止参与或对正在进行的随机临床试验“黑人及西班牙裔少数族裔 2 型糖尿病患者的远程医疗管理可行性（T2DM）”研究方案的不依从的原因。通过电话进行了半结构化访谈，包括开放式问题和提示，以评估患者对参与试验和使用远程医疗管理糖尿病的实际和感知挑战。将数据与原始临床试验的数据进行整理，随后进行内容分析，以确定总体主题和趋势。共完成了 8 次电话半结构化访谈。分析中出现的主题包括不感兴趣（47%）、不方便（33%）、缺乏感知益处（13%）、对糖尿病诊断缺乏认识（7%）和认为自己无法完全参与研究（7%）。采用远程医疗帮助少数族裔患者管理糖尿病具有很大的潜力，但受到患者因素的限制，如不感兴趣、不方便和缺乏感知益处。随着我们努力实现对未得到控制的糖尿病的差异患者的健康公平，对这些问题的认识和理解将变得至关重要。
