Development of a Telenutrition Program to Address Health Disparities Among Uninsured Patients With Diet-related Chronic Diseases

OBJECTIVES: Our previous study showed a high rate of diet-related chronic diseases among a multi-ethnic group of uninsured adults living in South Florida, supporting the need for increased patient nutrition education. While telenutrition may be a convenient way to improve access to nutrition education services, disparities in utilization of telehealth may hinder the effectiveness of such programs in free clinic settings. Therefore, the objective of this study was to assess utilization of telemedicine by uninsured patients in a free clinic in order to develop an effective telenutrition program for this population. METHODS: Electronic health data of adult patients (N = 402) seen in-person versus via telemedicine was analyzed. Patients were seen in two separate four-week timeframes. During the in-person timeframe, no telemedicine services were provided. During the telemedicine timeframe, no in-person visits were offered. Sample characteristics were determined using descriptive statistical analysis. Independent t-test and Chi-Squared test were used to compare numerical and categorical data, respectively. RESULTS: The in-person patient group (n = 272) included 65% females and 35% males with the mean age of 49.08 ± 14.56 years. The in-person group was composed of 26.5% Whites, 33.8% Blacks, 35.6% Asians, and 1.1% American-Indians. The telemedicine group (n = 130) included 70% females and 30% males with the mean age of 49.04 ± 14.82 years. The telemedicine group was composed of 25.4% Whites, 30.8% Blacks, 37.7% Asians, and 1.5% American-Indians. Comparison of telemedicine versus in-person visits showed no significant differences related to sociodemographic characteristics between visit types. CONCLUSIONS: As there were no significant demographic differences between patients seen via telehealth and in-person, telemedicine may be a useful tool for providing nutrition education. In the next step of this project, telemedicine will be used for delivery of a culturally and socioeconomically tailored telenutrition program for uninsured patients. FUNDING SOURCES: This research was supported by FIU-RCMI and FIU-CRUSADA.