Minal Patel, the John G. Searle Assistant Professor of Health Behavior and Health Education at the University of Michigan School of Public Health, was awarded a five-year $3.3 million grant from the NIH's National Institute of Diabetes and Digestive and Kidney Diseases to evaluate the effectiveness of an innovative e-health tool that helps people with uncontrolled diabetes manage unmet needs.
The electronic health tool helps people with diabetes address unmet social needs—difficulty with finances and insurance, healthy food access, employment—that may hinder them from managing their condition. Participants will learn how to use digital resources that provide information about their care and skills training on addressing unmet needs. They also receive other interactive communications that foster adherence.
"These concerns are not routinely addressed in clinical settings or conventional diabetes management education." —Minal Patel
Social determinants of health are critical issues that impact chronic disease management. "A broad, known literature shows that people with unmet social needs have significant difficulties managing their health and therefore have difficulties staying healthy," she said. "These concerns are not routinely addressed in clinical settings or conventional diabetes management education. We want to see if our intervention improves their ability to control a chronic disease," Patel said.
Patel's research focuses on how to optimize health care for patients, and she has led multiple studies looking at financial burdens as barriers to chronic disease management. One in two individuals in the US now manages a chronic disease, and one in four manages multiple. With most chronic diseases requiring long-term management with complex therapeutic regimens, Patel's work promises concrete recommendations for interventions that would address a critical gap in care without putting added burden on clinical visits.
Patel's work promises concrete recommendations for interventions that would address a critical gap in care without putting added burden on clinical visits.
"Current approaches to screen for and address health-related financial burden and unmet social determinants of health are fragmented and not offered to all patients with or at risk for poor health outcomes," Patel said. "This project brings something new to the table by providing a comprehensive, plain-language, e-health tool that guides patients through aspects of disease management, links them to resources, and offers skills training in effective communication with providers around these needs."
Patel hopes her team's work can provide more in-depth understandings of the extent to which identifying financial burdens and unmet social determinants of health before clinic visits, and engaging patients in self-care, can improve disease control and health outcomes. Such evidence will be necessary to reduce disparities and support wider adoption of new population management strategies within delivery systems.
Patel's collaborators on the study include: Michigan Center for Diabetes and Translational Research; Michigan Diabetes Research Center; Michele Heisler, Department of Health Behavior and Health Education, School of Public Health, Department of Internal Medicine, Michigan Medicine; Kenneth Resnicow, Department of Health Behavior and Health Education, School of Public Health; John Piette, Department of Health Behavior and Health Education, School of Public Health; Peter Song, Department of Biostatistics, School of Public Health; Hae Mi Choe, College of Pharmacy, Chief Quality Officer and Director of Pharmacy Innovations and Partnerships, U-M Medical Group.
Access to care, social determinants of health, racial equity in healthcare, chronic disease management, behavioral interventions
