Telehealth diabetes services for non-English speaking patients.

BACKGROUND: Several studies have shown the use of telehealth in diabetes management to be as efficacious as traditional clinic visits; however, these studies focused on English-speaking populations. OBJECTIVES: The primary objective of this study was to evaluate whether telehealth is an effective approach for participation in pharmacist collaborative diabetes management services among non-English-speaking or limited English proficiency (LEP) patients at a federally qualified health center (FQHC). The secondary objective was to evaluate glycated hemoglobin (A1c) as a clinical outcome in patients participating in telehealth versus in-person visits. METHODS: This study was a retrospective chart review. Patients were non-English-speaking or LEP adults (≥ 18 years of age) with a diagnosis of type-2 diabetes (T2D) referred for pharmacist collaborative diabetes management services by a medical provider. This study reviewed patient participation and A1c values over 6 months (May to October) of 2 consecutive years (2019 and 2020). RESULTS: In this study, 40 patients in 2019 and 50 patients in 2020 met the inclusion criteria. In 2019, the primary visit model was in-person and 123 total visits were scheduled with a pharmacist. In 2020, the primary visit model was telehealth and 143 total visits were scheduled. In 2019, there were 28 no-show visits, which accounted for 22.8% of total visits. In 2020, there were 27 no-show visits, which accounted for 18.9% of total visits. The mean change in A1c from baseline to follow-up was found to decrease by 1.0% in 2019 and 0.95% in 2020. CONCLUSIONS: We concluded that telehealth participation in pharmacist-provided collaborative T2D services and decrease in A1c were similar during telehealth compared with in-person visits among non-English-speaking and LEP patients at a FQHC. However, further studies with larger sample sizes are necessary to determine the overall impact of telehealth in non-English-speaking or LEP patients.

Metabolic Costs of a 58-minute Multi-Intensity Exercise Session with and Without Music and Cueing.

It is unclear if the presence or absence of music and cueing influence total energy expenditure (TEE) during a multi-intensity exercise program. The purpose of this study was to determine the difference between TEE with or without music and cueing during a 58-minute exercise session using heart rate estimation (HRe) and indirect calorimetry (IC). Using a randomized crossover design, 22 participants (6 males; 16 females; 27.64 ± 10.33 yrs.) were randomized into two groups (Group A = 11; Group B = 11). All participants performed the same 58-minute exercise session under two conditions: with music (WM) and without music and cueing (WOM). TEE was obtained through the Activio heart rate system for all 22 participants. TEE and excess post-exercise oxygen consumption (EPOC) were also obtained in a subset of eight participants (4 males; 4 females; 28.25 ± 5.9 yrs.) via IC through a ParvoMedics metabolic cart. Paired samples t-tests were performed to compare TEE between conditions using HRe and IC. Statistical analysis was performed using IBM Analytics, SPSS v24 with significance set at p < 0.05. A significant difference (p = 0.008) was found between TEE WM and WOM using IC (475.74 ± 98.50 vs. 429.37 ± 121.42), but not between TEE WM and WOM using HRe (p = 2.04; 482.67 ± 151.79 vs. 452.90 ± 164.59). The presence of music and cueing increased TEE when monitored via IC, but not when measured via wearable heart rate technology. Music and cueing does aid in additional caloric expenditure.

The Relationship Between Pedometer-Determined Ambulatory Activity and Balance Variables Within an Older Adult Population.

The purpose of this investigation was to determine the differences between gender, physical activity level, and balance in an older adult population. A secondary purpose was to examine the relationship between pedometer-determined ambulatory activity and balance. Forty-six older adults aged 73.7 ± 6.2 years participated in the study. Participants completed the Fullerton Advanced Balance (FAB) Scale and completed a 2-week daily step recording to determine average steps taken per day. Low-level activity participants (<5,000 steps/day) were significantly different from the high-level activity participants (>7,500 steps/day) in weight, age, and the number of medications reported. Males performed better than females on the two-footed jump test and reactive postural test FAB assessments. High-level activity participants performed significantly better than low-level activity participants on all FAB assessments except stand with feet together and eyes closed, reach forward to object, and walk with head turns.