Increasing Health Equity Through In-The-Moment Reading Assistance for Adults with Diabetes Served at Community Health Centers

This SBIR Phase I project will demonstrate GogyUp?s in-the-moment assistive reading technology to increase patients? ability to understand, manage and communicate about a chronic disease, a National Institute of Minority Health Disparities strategic priority. SIGNIFICANCE: Type two diabetes mellitus (T2DM) affects over 30 million Americans and requires patients to competently manage their conditions at home. However, patient educational print materials for after-visit care are overly complicated, with excessively high reading difficulty and fall short in supporting functional readiness for self-management. Compounding this inaccessibility are several barriers that limit patients? capacity to learn and build knowledge and health literacy (the ability to process health information to make health decisions), including low print literacy (18% of U.S. adults are unable to read basic sentences), and limited English proficiency. HYPOTHESIS: The research team will determine the feasibility for implementing the GogyUp Reader app (in-the-moment assistive reading technology) in adult health care and whether the app facilitates patient understanding for managing T2DM when compared to the established standard for after-visit care (print materials alone). Aim 1 is to determine the feasibility for using GogyUp Reader as an aid for using disease self-management education materials. The research team will recruit eligible patients with T2DM in safety net clinics within diverse Minnesota communities experiencing higher levels of health disparities and employ engagement and usage measures from internal app data to assess feasibility for this use case. Aim 2 is to conduct a pilot trial of GogyUp?s embedded in-the-moment assistive reading technology for functional health literacy. We will assess the potential effectiveness of GogyUp and the feasibility of conducting a larger, multicenter trial by conducting a pilot randomized trial with a randomized, pre-post design. Outcomes will include functional health literacy, or the ability to read and understand written health materials in the moment as a proximal outcome (primary) and communicative and critical health literacy, or the ability to communicate about and critically appraise self-management activities (secondary), from baseline to three months. PRELIMINARY DATA: End-user data from individual app users and adult education pilots indicate broad uptake among an all-volunteer user base. A randomized trial is needed to assess the technology?s potential impact on health literacy and its applicability for reducing health disparities. LONG TERM GOAL: This real-world application and assessment of the GogyUp Reader app for T2DM will inform system improvements and provide initial data for a Phase II project as a fully powered, multi-year randomized controlled trial to evaluate GogyUp?s assistive reading technology on patient health literacy, commercialization strategy, and reveal best practices for culturally responsive implementation and support.