DOI: 10.2337/db23-68-or ISSN: 0012-1797

68-OR: Digital Divide and Medicare Diabetes Prevention Program of Beneficiaries with Elevated BMI

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

The Medicare Diabetes Prevention Program (MDPP) encourages beneficiaries with prediabetes to build healthy lifestyle behaviors that reduce the risk of diabetes. Limited supply of in-person MDPP and telehealth growth, support virtual delivery of MDPP. Success of virtual MDPP is impacted by access to digital devices and the Internet. A survey-weighted multinomial logit model was performed to examine associations between socio-demographics, comorbidities, and computer access and internet usage among beneficiaries. Using the 2020 nationally representative Medicare Current Beneficiary Survey PUF, a three-level categorical dependent variable was created: (1) has a computer AND uses internet, (2) has a computer OR uses internet, and (3) has no access to either (reference group). Of beneficiaries reporting BMI ≥ 25 kg/m2 and no diabetes history (n=3,912), 70.6% had a computer AND used internet; 14.2% had a computer OR used internet; and 15.2% lacked a computer and did not use internet. Hispanics, Non-Hispanic Blacks (NHB), and Others were less likely to have a computer AND use internet than non-Hispanic Whites (NHB, OR=0.27; p<0.001). Beneficiaries with lower educational attainment (<high school (HS) and HS) were less likely to have a computer AND use internet (<HS, OR=0.04; p<0.001) or have a computer OR use internet (<HS, OR=0.21; p<0.001) than those with college education. Beneficiaries with lower incomes (<$25,000) were less likely to have a computer AND use internet (OR=0.24; p<0.001) or have a computer OR use internet (OR=0.58; p<0.001) than those with higher incomes. This study found that ~30% of beneficiaries likely eligible for MDPP (potentially representing 6 million beneficiaries) lack digital tools for virtual MDPP. Digital divides by race/ethnicity, income, and education were observed. Efforts to improve access and enrollment in MDPP using virtual delivery must consider digital access to avoid technological disparities among populations with heightened type 2 diabetes risk.


B.Ng: None. J.B.Lamanna: None. M.Massey: None. G.T.Hawkins: None. C.Park: None.

More from our Archive