BACKGROUND: In the aftermath of COVID, there is an increased need to understand the utility of electronic health technologies (eHealth) in the self-management of chronic health conditions.

OBJECTIVES: To evaluate how eHealth relates to patient engagement (i.e., patient activation, preventive behaviors) and health outcomes among adults with type 2 diabetes mellitus (T2DM). Also, to provide a baseline reference of eHealth use in this population prior to COVID.

METHODS: Data were obtained from the 2019 US National Health and Wellness Survey, a nationally representative survey of health in the adult population. Included were adults (18+ years) with a self-reported physician diagnosis of T2DM. Variables included socio-demographics, eHealth use, patient activation (PAM, which evaluates patients’ willingness and ability to manage their own health), preventive behaviors for T2DM (e.g., dietary changes, exercise), and health outcomes (e.g., comorbidities, hypoglycemic events, HbA1c/blood glucose levels). Respondents were categorized by eHealth use (0, 1, or ≥2 technologies). Chi-square tests and ANOVAs were used to evaluate the relationship between eHealth use and other study variables.

RESULTS: Analyses included N=5942 adults with T2DM. Greater eHealth use (0 vs. 1 vs. ≥2 technologies) was associated with greater patient activation (PAM=62.3 vs. 62.7 vs. 64.5), more frequent exercise (5.1 vs. 6.6 vs. 8.1 days/month), more preventive behaviors (2.5 vs. 2.9 vs. 3.2 total behaviors), and lower BMI (33.4 vs. 32.9 vs. 32.4 kg/m²) (all, p<0.01). Greater eHealth use was also associated with higher self-reported HbA1c levels (7.0% vs. 7.0% vs. 7.3%), a greater number of comorbidities (4.1 vs. 4.2 vs. 4.6), and a higher likelihood of having experienced a hypoglycemic event in the past year (60.4% vs. 66.6% vs. 69.2%) (all, p<0.001).

CONCLUSIONS: eHealth use was positively associated with patient activation and preventive behaviors. Future studies should examine how post-COVID changes in eHealth adoption relate to patient engagement and health outcomes.