Date of Conferral

6-4-2024

Date of Award

June 2024

Degree

Ph.D.

School

Public Health

Advisor

Tolu Osoba

Abstract

The incidence of Type 2 diabetes mellitus (T2DM) is on the rise, particularly among adults aged 18 years and older. Glycosylated hemoglobin (HbA1c) levels are commonly used by healthcare professionals to assess glucose variability; fluctuations are associated with an increased risk of adverse effects. The COVID-19 pandemic highlighted the importance of self-directed management of HbA1c levels through telehealth. The purpose of this retrospective quantitative study was to investigate the effectiveness of self-directed management of HbA1c levels using telehealth among T2DM diagnosed adults at a community health service organization in the northeastern U.S. from December 2018 to 2022. Using multivariate regression analysis, relationships between HbA1C levels (dependent variable) and the independent variables of telehealth consultation, clinical consultation, and participation in diabetes education, including covariates of gender, age, ethnicity, BMI, geographic location, and comorbidities, were explored. Key findings indicate that age, BMI, telehealth utilization, and occupation are statistically significant predictors of HbA1c levels, while gender, education, health insurance, geographical location, and comorbidities like retinopathy, nephropathy stages, and coronary heart disease are not. Telehealth consultations and neuropathy had a significant relationship with HbA1c levels but accounted for a small percentage of the variance. Implications for positive social change include the importance of diabetes educational programs focusing on lifestyle changes, diet, physical activity, screening, and medication adherence to improve health outcomes and self-management through community support and telehealth initiatives in vulnerable populations.

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