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Don’t Let Improved Diabetes Numbers Lull You into Complacency


Nearly half of Americans have diabetes or pre-diabetes, and that’s good news—at least according to the experts. University of Michigan researchers recently published a paper in JAMA that notes that after climbing steadily for two decades, diabetes diagnoses have leveled off. Still the 50 percent rate represents a serious public health issue that demands on-going patient engagement strategies for the millions of Americans who still require targeted education to help them manage their conditions.

Tackling a Serious Public Health Issue

In an article accompanying the study’s findings, authors William Herman and Amy Rothberg suggest that much-publicized food, nutrition and activity guidelines have helped, noting that “Although obesity and Type 2 diabetes remain major clinical and public health problems in the United States, the current data provide a glimmer of hope.” From 2008 to 2012, the percentage of individuals diagnosed with diabetes remained static. The next challenge, of course, is to move the needle downward from its current steady, but high, diagnosis rate.

To do so effectively, healthcare providers and public health organizations need to develop patient engagement strategies that go beyond one-size-fits-all messaging because a shared diagnosis could be the only thing individuals with diabetes have in common. Demographics, for example, can guide some strategy development. While the number of people who had undiagnosed diabetes declined by 9 percent in recent years, certain racial and ethnic groups failed to see such a decrease.

The study found that:

  • Mexican Americans are more likely to have undiagnosed diabetes than Caucasians and African Americans.
  • Asian Americans are more likely than any other group to have undiagnosed diabetes.

Herman and Rothberg suggest that lower access to healthcare may be one cause for the disparity among Mexican Americans, but it’s possible that engagement initiatives are falling short for other reasons as well. Denial, busy lifestyles—whatever the reason—some people fail to act on information that is readily available. Such was the case for Mary Tyler Moore, an outspoken advocate for diabetes research and education, who was diagnosed with Type 1 diabetes just when the Mary Tyler Moore Show was being launched. She admitted, “I’ve always been independent. I’ve always had courage. But I didn’t always own my diabetes.” She said that career and motherhood both took precedence for a number of years.

Using Consumer Research and Psychographic Segmentation to Increase Engagement

Hospitals and other healthcare organizations that in the past relied on more generic engagement strategies must think more like retailers when it comes to dealing with today’s healthcare consumers—and that requires deeper insights into who they’re trying to reach, where they need to reach these prospects and what messages will resonate with individual consumers. Healthcare consumer research and psychographic segmentation can help. How?

As we’ve noted before, our Consumer Diagnostic indicates that Type 2 diabetes is far more prevalent, relative to Type 1 diabetes, among diagnosed survey respondents at 88 percent. These patients show distinct differences from their counterparts with Type 1 diabetes, tending to be older, more conservative and less likely to exercise. Moreover, among all consumers with diabetes, the two most common psychographic segments are Self Achievers and Willful Endurers, two patient types with almost exact opposite approaches to health and wellness. As a result, a single patient engagement strategy for the entire population of patients with diabetes—or pre-diabetes, by extension—is likely to fall short for large segments of the population.

Instead, patient engagement strategies must embrace the differences and leverage messaging in ways that are designed to better engage individuals. For example, our research suggests:

  • Individuals with Type 1 diabetes are statistically more likely to use health apps on their smartphones or tablets than are those with Type 2 diabetes, so an app designed to help with diabetes management could be a positive engagement tactic for these patients.
  • Individuals with Type 1 diabetes are also more likely than those with Type 2 diabetes to visit health-oriented websites. 
  • On the other hand, individuals with Type 2 diabetes are almost twice as likely as those with Type 1 diabetes to indicate that their Primary Care Physician, a specialist physician or a Nurse Practitioner are the most influential sources of information regarding diabetes. 

Empowering Self Achievers with self-care resources will be appreciated by this patient type, while Willful Endurers will require more active intervention by healthcare professionals.

By addressing the unique differences among healthcare consumers at risk or already diagnosed with diabetes, healthcare organizations may be able to develop patient engagement strategies that succeed in creating some downward momentum for diabetes diagnoses.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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