Innovative Tailored Microlearning Approach to Insulin Self-Management Education Shows High Engagement Levels among Diverse Adults
Authors: BOGUN MAGDALENA M. , JELESOFF NICOLE E. , NASSAR CARINE M. , THACKER CONNIE R. , RIVERA JOHANNA CAMACHO , BOURGES CLAYTON J. , SETHI KARAN , EGBUONU-DAVIS LISA , BEAL ANNE C. , GREENWOOD DEBORAH A. , CHATHA HERLENE , KATARIA ANJALI , MCNEILL DIANA B. , GOLAND ROBIN , MAGEE MICHELLE F. 
Published: June 2018

Self-management education for adults with type 2 diabetes (T2DM) improves knowledge, skills and motivation; yet, new strategies to more effectively educate patients and improve adoption of insulin therapy are still needed. We conducted a prospective, non-randomized multi-center pilot, using a novel Patient Experience Cloud to deliver microlearning education focused on survival skills, insulin injection technique, and lifestyle management. Content was culturally relevant and tailored to minority patients with T2DM who recently initiated insulin treatment to enhance engagement. Consented T2DM adults, ages 20 to 70 years, were presented an online library of 56 education videos (1-4 minutes each). Pre and post surveys of self-reported attitudes towards insulin and patient activation measures (using the validated PAM scale) were obtained. The study enrolled 201 patients: 78 non-Hispanic whites (NHWs), 74 African Americans (AAs), 39 Hispanic whites (HWs) and 10 Other. Of these, 181 (90%) were engaged (defined as completing baseline surveys and watching 4+ videos). The number of videos viewed differed by race, p=0.012; with median number of 23 for AAs, 13 for NHWs and 5 for HWs. One week later, 83 participants (41%) continued engagement via viewing and completion of post questionnaires. Highest engagement was seen among AAs (51%) vs. 40% of NHWs and 26% of HWs. Overall attitudes towards insulin improved significantly, with a mean change of 0.29 points (on a 6 point Likert scale, 95% CI 0.02 to 0.56, p=0.03). Similarly, the PAM score increased significantly after viewing (by 0.17 point on a 4 point scale, 95% CI 0.to 0.26, p&lt;0.001), independent of race. After viewing culturally tailored microlearning delivered via a cloud platform, patient attitudes towards insulin and activation measures for self-care improved significantly. This novel approach should be further investigated for its ability to improve adherence to insulin and glycemic outcomes.

Disclosure
M.M. Bogun: Other Relationship; Self; Mytonomy. N.E. Jelesoff: None. C.M. Nassar: None. C.R. Thacker: Other Relationship; Self; Amylin Pharmaceuticals, AstraZeneca, Mytonomy. J. Camacho Rivera: Research Support; Self; Mytonomy. C.J. Bourges: None. K. Sethi: None. L. Egbuonu-Davis: Employee; Self; Sanofi. A.C. Beal: Employee; Self; Sanofi. Board Member; Self; AcademyHealth. D.A. Greenwood: Advisory Panel; Self; Novo Nordisk A/S. Consultant; Self; Verily Life Sciences LLC.. Speaker's Bureau; Self; Becton, Dickinson and Company. Employee; Self; Mytonomy, Inc. Advisory Panel; Self; American Association of Diabetes Educators. H. Chatha: Employee; Self; Mytonomy. Employee; Spouse/Partner; Medstar Health. A. Kataria: Stock/Shareholder; Self; Mytonomy, Inc. Stock/Shareholder; Spouse/Partner; Mytonomy, Inc. D.B. McNeill: None. R. Goland: None. M.F. Magee: Research Support; Self; Sanofi, Eli Lilly and Company, MedStar Health Research Institute. Advisory Panel; Self; Merck & Co., Inc.. Research Support; Self; PRIMED. Speaker's Bureau; Self; IMNE, American Diabetes Association. Advisory Panel; Self; Endocrine Society. Speaker's Bureau; Self; Sanofi. Research Support; Self; MedStar Health.