A Social Media-Based Intervention Improves Glycemic Control in a Low-Income Older Immigrant Population

ABSTRACT

Purpose: Access to in-person diabetes self-management education (DSME) programs is limited in underserved immigrant communities. In this report, we examined the feasibility, acceptability, and potential efficacy of a social media-based DSME intervention in low-income older Chinese immigrants with type 2 diabetes (T2D). Methods: This was a single-group study in 30 Chinese immigrants with T2D living in NYC. The intervention included 24 culturally and linguistically tailored DSME videos. Over 12 weeks, participants received 2 brief videos each week via WeChat, a free social media app popular among Chinese immigrants. Feasibility was defined as ability to achieve 1) the recruitment goal (n=30);2) >80% retention;and 3) >80% watch rate. Acceptability was assessed via a satisfaction survey at 6 months. HbA1c was collected at baseline and 6 months Results: Recruitment was completed prior to the NYC COVID-19 lockdown. Despite COVID-19, the intervention continued without interruption. Participants were mostly female (70.0%), married (63.3%), with limited English proficiency (86.7%), and a mean age of 61.2 (SD=6.7) years old. Most reported an annual household income of < $25,000 (84.0%) and an education of high school or less (63.3%). Thirty participants were recruited within 2 months, 93.3% were retained at 6 months, and a video watch rate of 92.2% was achieved. The mean baseline HbA1c was 7.4% (SD=1.2) and declined by 0.6% (95% CI 0.3%-0.9%, p=0.001) to 6.8% (SD=0.8) at 6 months. Participants expressed high satisfaction (96.4%), and all strongly agreed or agreed that they preferred this video-based DSME to face-to-face visits. Conclusions: This pilot study demonstrated that a social media-based DSME intervention is feasible, acceptable, and potentially efficacious in an aging low-income immigrant population with T2D. These findings provide timely implications in the era of COVID-19, suggesting older low-income immigrants can be engaged in mHealth interventions.