Mirame Salud: Immersive Diabetes Self-Management Training for Latino Americans

ABSTRACT Diabetes affects 37 million Americans at an annual cost of $412 billion. Latino Americans (Latinos) are disproportionately affected by type 2 diabetes (T2DM), compared with the general population (12.6% vs. 6.9% prevalence) at a cost of $8865pp/yr. They are twice as likely to incur diabetes complications and 1.3 times more likely to die of diabetes. Self-management struggles are also stark with low rates of medication adherence, physical activity, and increased diabetes distress. To , curb escalating prevalence and mitigate costs and health disparities, a population health solution is urgently needed that serves patients’ self-care needs and equips providers and payors with tools to intervene before costly complications are incurred. Essential to population health management is effective patient engagement -- to bolster patients’ digital literacy, health literacy and self-management skills to enable them to serve as high-performing care partners. mHealth for diabetes uses smart phones to deliver digital diabetes tools and services and to reach patients who struggle with access to care. Yet, barriers to digital resources still stymie these health promotion efforts. Specifically, language, digital literacy, and other barriers interfere with the ability for Latinos to meaningfully engage with digital diabetes care apps and technologies. Many Latinos also require educational resources in Spanish. Yet, only 22% of diabetes apps are translated into Spanish, and some solutions, such as immersive technologies, until recently could not be accessed with smartphones. SYH’s team uses avatar-driven immersive technology to deliver highly engaging experiential patient education and telehealth services. Our proprietary instructional game design boosts patient engagement in self-management training and overcomes reading and digital literacy barriers by reducing demand on reading skills and instead leverages experiential learning. An ideal digital health tool for Latinos with T2DM is a mobile application offering immersive tailored DSMT experiences and social support that can eventually be integrated with population management tools in a hub platform. SYH has proven expertise in developing health literacy programs for older, less technically-inclined populations with chronic disease. Our Phase I goal is to create and test usability of a new platform, Mirame Salud, a tailored diabetes care hub, using SYH’s novel constructivist curriculum, virtual/augmented reality, and WebXR technology, to deliver immersive, interactive DSMT programs with smartphones for Latino Americans.