Digital Health Solutions Survey for African-American Type 2 Diabetes Patients

Digital Health Survey of African-American Diabetes Patients

Survey Research

Responsible Investigator: Dr. Neil Maniar Student Investigator: Bijoy Sagar Title of Protocol: Policy Barriers To The Adoption Of Digital Health Interventions In The Management Of Chronic Type-2 Diabetes Among Marginalized Adults African American In The United States Start Survey

You have been requested to participate in the research study that aims at investigating: a) barriers to accessing care, general health and concerns regarding your Diabetes Type-2 experience and openness to using digital therapies and b) your views on technology.
You will be asked to take the onlinesurveywhich will take approximately 30-45 minutes to complete.
Completing the survey involves no risk to you.
You must be over 18 years to participate renumber the rest.
All participants of this survey are eligible to participate in a raffle for $500 Amazon web certificate. Participation is voluntary. If you choose to participate, an email address needs to be provided at the end of the survey to reach you if you win. All email addresses will be deleted immediately after the raffle. The raffle will take place a day after the survey is closed and winner will be notified by email with electronic gift card.
Type-2 Diabetes black patientswill benefit if this research is used to set policies that address barriers in adopting a new promising way to manage the disease (Digital Tools) and change the design to make it more friendly and easy to use.
Although the results of this study may be published, no information that could identify you will be retained or included. The survey data will be stored electronically under the care of Bijoy Sagar and will be maintained and retained for the period necessary for academic purposes under strict confidentiality and care as is possible.
Questions about this research may be addressed to Dr. Neil Maniar at 617.373.5925. Complaints about the research may be presented to privacy@neu.edu.. Questions about research subject’s rights or research-related injury may be presented to to be filled in.
No service of any kind, to which you are otherwise entitled, will be lost or jeopardized if you choose to “not participate” in the study.
Your consent is being given voluntarily. You may refuse to participate in the survey. If you decide to participate in the survey, you are free to withdraw at any time without any negative effect on you relations with NortheasternUniversity or with any other participating institutions or agencies. By clicking “I agree” at the bottom of page, you agree that you understood the information provided on this page and voluntarily consent to participate in the survey.
You may downloada copy of this letter for your records. Thank you for participating in this survey.

Sincerely, Bijoy Sagar for Dr. Neil Maniar Address: Dr. Neil Maniar, Associate Chair & Professor of the Practice and Director, Master of Public Health in Urban Health Program, Department of Health Sciences, 316 K Robinson Hall, Northeastern, University, Boston, MA 02115 Start Survey

Digital Health Survey of African-American Diabetes Patients

survey form

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Demographic Questions

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First Name

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Survey
Research

Responsible Investigator: Dr. Neil Maniar

Student Investigator: Bijoy Sagar

Title of Protocol: Policy Barriers To The Adoption Of Digital Health Interventions In The Management Of Chronic Type-2 Diabetes Among Marginalized Adults African American In The United States

You have been requested to participate in the research study that aims at investigating: a) barriers to accessing care, general health and concerns regarding your Diabetes Type-2 experience and openness to using digital therapies and b) your views on technology.
You will be asked to take the onlinesurveywhich will take approximately 30-45 minutes to complete.
Completing the survey involves no risk to you.
You must be over 18 years to participate renumber the rest.
All participants of this survey are eligible to participate in a raffle for $500 Amazon web certificate. Participation is voluntary. If you choose to participate, an email address needs to be provided at the end of the survey to reach you if you win. All email addresses will be deleted immediately after the raffle. The raffle will take place a day after the survey is closed and winner will be notified by email with electronic gift card.
Type-2 Diabetes black patientswill benefit if this research is used to set policies that address barriers in adopting a new promising way to manage the disease (Digital Tools) and change the design to make it more friendly and easy to use.
Although the results of this study may be published, no information that could identify you will be retained or included. The survey data will be stored electronically under the care of Bijoy Sagar and will be maintained and retained for the period necessary for academic purposes under strict confidentiality and care as is possible.
Questions about this research may be addressed to Dr. Neil Maniar at 617.373.5925. Complaints about the research may be presented to privacy@neu.edu.. Questions about research subject’s rights or research-related injury may be presented to to be filled in.
No service of any kind, to which you are otherwise entitled, will be lost or jeopardized if you choose to “not participate” in the study.
Your consent is being given voluntarily. You may refuse to participate in the survey. If you decide to participate in the survey, you are free to withdraw at any time without any negative effect on you relations with NortheasternUniversity or with any other participating institutions or agencies. By clicking “I agree” at the bottom of page, you agree that you understood the information provided on this page and voluntarily consent to participate in the survey.
You may downloada copy of this letter for your records. Thank you for participating in this survey.

Sincerely,

Bijoy Sagar for Dr. Neil Maniar

Address: Dr. Neil Maniar, Associate Chair & Professor of the Practice and Director, Master of Public Health in Urban Health Program, Department of Health Sciences, 316 K Robinson Hall, Northeastern, University, Boston, MA 02115

Untitled*

I voluntarily agree to participate in the survey

What is your CURRENT age?*

Please enter a number from 18 to 99.

What race or races do you consider yourself to be?*

Asian

Black

Other

White

What ethnicity do you consider yourself to be?*

Hispanic

Non-Hispanic

What gender do you consider yourself to be?*

Male

Female

Other

What was your income in LAST YEAR BEFORE TAXES*

Over 75000

50000-75000

30000-50000

15000-30000

Under 15000

Zip code of your address*

Is English your primary spoken language?*

YES

DO NOT KNOW

What is your IMMIGRANT STATUS?*

Natural born citizen

Naturalized citizen

Legal resident

Other

Do you CURRENTLY live with (check all that apply)*

Alone

Partner/spouse

Children

Other family members (s)

Other non-family members

Are you now married, living with a partner as an unmarried couple, or neither?*

Married

Living with a partner together as an unmarried couple

Neither

What is the highest degree or level of school you have completed?*

No school

Below 11th grade

12th grade, no diploma

Regular high school diploma

GED or equivalent

Some college

Associates Degree

Bachelor’s Degree

Post-graduate degree (Master’s, Professional post-graduate, or Doctorate)

The house apartment or mobile home where you currently live*

Owned by you or someone in your household with a mortgage or loan

Owned by you or someone in your household free and clear (without a mortgage or loan)

Rented with government subsidies or vouchers

Occupied without payment

Rented at market price

What is your employment status?*

Full-time

Part-time

Seeking opportunities currently

Retired

Prefer not to say

Your total FAMILY income in LAST YEAR BEFORE TAXES (total amount that all individuals in your homemade within the last year?)*

Less than $25,000

Between $25,000-$75,000

Between $75,000-$125,000

More than $125,000

Prefer not to say

How will you describe your general state of health?*

Do you have a disability?*

Yes

Do not know

If yes, do you use any of the following… (Check all that apply)*

Cognitive

Anxiety

Seeing

Hearing

Speaking

Using arms

Using hands/fingers Walking, climbing stairs

Do not know

In general, how satisfied are you with your life? Are you:*

Very Satisfied

Satisfied

Dissatisfied

Very dissatisfied?

How have you been feeling or acting in the past two weeks?*

Mostly happy

Sometimes happy

Sometimes miserable or unhappy

Very dissatisfied?

Do not know

If you answered YES to the questions above, do you have a primary caretaker for your health or disability-related needs?*

Yes

Do not know

What is your relationship with your primary caretaker?*

Partner/Spouse

Another relative

Non-relative

A social worker or another government-appointed caretaker

No caretaker

Do not know

Does the primary caretaker influence your health decisions and choices*

Yes

Somewhat

Do not know

Do other members of your family influence your health decisions and choices*

Yes

Somewhat

Do not know

Do friends, community members you know, or religious figures in your life influence your health decisions and choices*

Yes

Somewhat

Do not know

During the past 12 months, how many times have you gone to a hospital emergency room about your health?*

During the past 12 months, have you delayed getting medical care because of the cost?*

Yes

There are many other reasons people delay or do not get medical care. During the past 12 months, did you delay or not get medical care for other reasons?*

Yes

Do you have health insurance?*

Yes

Don’t know

If YES, what sort of insurance do you have?*

Private

Medicare

Medicaid

Other Government

Other

None

In your opinion, how well do you agree with the following statement? “I trust my hospital system.”*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

In your opinion, how well do you agree with the following statement? “I trust my doctor.”*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

In your opinion, how well do you agree with the following statement? “My hospital system wants the best for me and offers me the best choice in treatment.”*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

In your opinion, how well do you agree with the following statement? “My doctor wants the best for me and offers me the best choice in treatment.”*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Has a doctor or other health professional ever told you that you had prediabetes or borderline diabetes?*

Yes

Don’t know

Has a doctor or other health professional ever told you that you had diabetes?*

Yes

Don’t know

How old were you when a doctor or other health professional FIRST told you that you had diabetes*

Please enter a number from 0 to 99.

Insulin can be taken by shot or pump. Are you NOW taking insulin?*

Yes

Are you NOW taking diabetic pills to lower your blood sugar? These are sometimes called oral agents or oral hypoglycemic agents.*

Yes

Thinking back to when you were first diagnosed with diabetes, how long was it before you started taking insulin?*

Yes

According to your doctor or other health professional, what type of diabetes do you have? Is it type 1, type 2, or some other type? If you don’t remember or weren’t told, that’s OK.*

Type 1

Type 2

Other

Do not know

Has a doctor or other health professional EVER told you that you currently have any other disease? If yes, please select all that apply (chronic disease)*

Hypertension

Cholesterol

Cardiovascular Conditions

Asthma

Cancer

Other Chronic Conditions

None of the above

Do you own or use a cellphone, smartphone, or Tablet? (Select all that apply)*

Cellphone

Smartphone

Tablet

None

What kind do you use if you own or use a cell phone or Tablet? (Check all that apply)*

Basic Cellphone

A basic cellphone (e.g., Motorola Razr, Pantech Breeze, Nokia 6350)

Smartphone (e.g., iPhone, Android phone, BlackBerry, Windows phone)

Tablet (e.g., iPad, Kindle Fire, Galaxy Tab, Google Nexus)

Other (iPod Touch, Nook, Kindle, netbook, laptop)

When you use the internet, do you access it through (check all that apply)*

Mobile phone or smartphone

Personal tablet or computer

Borrowed Tablet or computer

Community access (e.g., Library)

I do not access the internet

How often do you use the internet per week?*

Voluptatem suscipit*

Business

Personal work (e.g., paying a bill)

Entertainment

Look up health information

Other

I do not access the internet

Praesentium aut omni

In your opinion, please rate the following statement. Internet is easy to learn and use.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

In your opinion, please rate the following statement. Mobile phones are easy to learn and use*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Has a doctor or other health professional EVER suggested that you use an internet tool such as an app, electronic software system, a wearable product like a digital watch, or another such tool to monitor and/or manage your diabetes?*

Yes

Don’t know

If yes, did you download or log in to such a tool or device?*

Yes

If not, what were the reasons you did not follow the recommendation of the doctor (check all that apply)*

Lack of time or motivation

Skeptical of its ability to help me

Cost

Lack of comfort with technology

Other

If other, please state the reason*

Are you currently using the tool?*

Yes

If you answered no to question 45, how long did you use it before you discontinued the tool?*

Within the 1 week

Longer than a week but under 6 weeks

3-6 months

More than 6 months

Did not discontinue

Who helped you with the set-up of the tool?*

What were the reasons you discontinued the tool (check all that apply)*

Lack of time or motivation

Skeptical of its ability to help me

It did not work

Cost

Lack of comfort with technology

Disability or other medical reason

Other

If your doctor or a healthcare professional ever suggests the use of software or a mobile phone app in the future to manage your health, how willing are you to adopt the tool as a way to manage your disease?*

Extremely willing

Willing

Somewhat willing

Unsure

Unwilling

Which of the following reasons are important in making your decision to try to adopt such a tool? (check all that apply)*

Trust in doctor or healthcare provider

Ease in use or simple design

Low cost

With the help of family member

Other

In your opinion, how true is the following statement? “I always have a friend or a family member who could teach me how to use a digital health tool .”*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

In your opinion, how true is the following statement? “A digital health tool is a helpful way to manage my health condition .” **

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Thank you for completing this survey.

I am interested in providing my email for the raffle

I am not interested

Email*

Number*

Digital Health Solutions Survey for African-American Type 2 Diabetes Patients

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Digital Health Survey of African-American Diabetes Patients

Survey Research

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Digital Health Survey of African-American Diabetes Patients

survey form

Demographic Questions

Survey
Research