Introduction and Objective: Our previous studies demonstrated that a telehealth-supported Community Health Worker (CHW) intervention significantly improved clinical outcomes in diabetes care. However, the extent to which these benefits vary across different age groups remains unclear.Methods: The aim of this study was to assess the effectiveness of the intervention in changing HbA1c across different age groups. We conducted a retrospective analysis of 10 studies (n=301) examining CHW-led multidimensional diabetes programs targeting low-income Hispanic adults with or at risk for type 2 diabetes. The intervention encompassed (1) CHW-participant coaching and support via mobile health (mHealth) with documentation of key conversation points on a team spreadsheet, (2) monthly CHW-led group education sessions, and (3) bidirectional mHealth feedback among participants, CHWs, and clinicians. We reported changes in HbA1c by age for adults aged 40-74 years from baseline to six months. Additionally, we analyzed the team spreadsheet containing CHW-participant conversation data to explore potential age-related variations in medication concerns.Results: HbA1c levels improved across all age groups from baseline to six months, with statistically significant reductions observed in individuals aged 40 to 66 years (p<0.05). As age increased from 40 to 49 years (n=78), HbA1c reductions moved from -0.83 to -1.18 (p=0.013 to p<0.001). By age 50 to 65 years (n=182), the trend reversed, with smaller improvements observed as age increased (-1.16% to -0.61%, p<0.001 to 0.016). Beyond 65 years (n=27), HbA1c changes plateaued and were not statistically significant. Medication-related concerns were more prevalent among adults ≥65 years, (73.7%) compared to those <65 years (44.1%) (p=0.014).Conclusion: HbA1c improved across all ages except in older adults, suggesting that age may play a role in intervention effectiveness. Targeted strategies and further research are needed to understand and address these age-related differences.
E.M. Vaughan: None. C. Johnston: None. A. Amspoker: None. S. Virani: None. A. Balasubramanyam: None. C.M. Ballantyne: Research Support; Abbott Diagnostics. Consultant; Abbott Diagnostics, 89bio, Inc. Research Support; Akcea Thearpeutics, Inc, Amgen Inc. Consultant; Amarin Corporation, Amgen Inc. Research Support; Arrowhead Pharmaceuticals, Inc. Consultant; Arrowhead Pharmaceuticals, Inc, AstraZeneca, Denka Seiken, ESPERION Therapeutics, Inc., Genentech, Inc, Illumina. Research Support; Ionis Pharmaceuticals. Consultant; Ionis Pharmaceuticals, Eli Lilly and Company. Research Support; Merck & Co., Inc. Consultant; Merck & Co., Inc. Research Support; NewAmsterdam Pharma. Consultant; NewAmsterdam Pharma. Research Support; Novartis Pharmaceuticals Corporation. Consultant; Novartis Pharmaceuticals Corporation. Research Support; Novo Nordisk. Consultant; Novo Nordisk. Research Support; Roche Diagnostics. Consultant; Roche Diagnostics. L.R. Porterfield: None.
NIH/NIDDK (R01 DK129474)
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