Telehealth interventions to improve diabetes management among Black and Hispanic patients: a systematic review and meta-analysis.
Open accessAbstract
Background Previous systematic reviews have found that telehealth is an effective strategy for implementing interventions to improve glycemic control and other clinical outcomes for diabetes patients. However, these reviews have not meaningfully focused on Black and Hispanic patients-partly because of the lack of adequate representation of people from racial and ethnic minority groups in clinical trials. It is unclear whether telehealth interventions are effective at improving glycemic control among Black and Hispanic patients given the disproportionate number of barriers they face accessing health care.Objectives A systematic review and meta-analysis of randomized control trials that used telehealth interventions for improving glycemic control among Black and Hispanic diabetes patients.Methods We reviewed PubMed, Embase, Web of Science, CINAHL, PsycINFO, and clinicalTrials.gov from inception to March 2021. We used a narrative summary approach to describe key study characteristics and graded the quality of studies using two reviewers. The pooled net change in HbA1c values was estimated across studies using a random-effects model.Results We identified 10 studies that met our inclusion and exclusion criteria. Nine studies were included in the meta-analysis. Only one study was rated as having low bias. Telehealth interventions were primarily delivered by telephone calls, text messages, web-based portals, and virtual visits. Most interventions involved delivering diabetes self-management education. Telehealth intervention pooled across studies with a mix of Black and Hispanic participants (> 50% sample) was associated with a - 0.465 ([CI: - 0.648 to - 0.282], p = 0.000) reduction in HbA1c.Conclusions Our findings suggest telehealth interventions are effective at improving glycemic control among Black and Hispanic diabetes patients.
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Virtual, telehealth, or internet-based diabetes self-management education and support services have benefits for diabetes prevention and management in a wide variety of populations.
“Strong evidence now exists on the benefits of virtual, telehealth, or internet-based DSMES services for diabetes prevention and management in a wide variety of populations (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [52]
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Equity in Medical Care for People Living With Diabetes
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Ehrhardt, N. M., Montour, L., Berberian, P., Vasconcelos, A. G., Comstock, B. A., & Wright, L. A.-C. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251331526 · Cited by 7 · see citing works
“11,13 Despite the recent rise in the use of telemedicine, 14 which provides a way to address difficulty accessing diabetes education; it is often underutilized among vulnerable groups like the Latino population.”
Telenursing as an Effective Ally for Improving Patient Outcomes in Diabetes? An Umbrella Review
Monaco, M. L., Profeta, A., & Corrao, S. (2025) · Nursing Open · doi:10.1002/nop2.70265 · Cited by 10 · see citing works
Choi, S. L., Hites, L., Bolland, A. C., Lee, J., Payne‐Foster, P., & Bissell, K. L. (2022) · Aging & Mental Health · doi:10.1080/13607863.2022.2149696 · Cited by 7 · see citing works
“Particularly, telehealth can be an important means for Black populations to improve managing diseases, given their high barriers to in-person healthcare (see Anderson et al., 2022).”
BackgroundBober, T., Rothenberger, S., Lin, J., Ng, J. M., & Zupa, M. F. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968231176303 · Cited by 6 · see citing works
Younger Women’s Experiences of Stroke: A Qualitative Study
Tarihoran, D. E. T. A. U., Honey, M. L. L., & Slark, J. (2023) · Nursing Praxis in Aotearoa New Zealand · doi:10.36951/001c.73355 · Cited by 7 · see citing works
Litchfield, I. J., Gale, N. K., Greenfield, S., Shukla, D., & Burrows, M. (2025) · Frontiers in Health Services · doi:10.3389/frhs.2024.1499847 · Cited by 6 · see citing works
“Patients might be signposted to community-based resources associated with, or contracted by, the NHS including local pharmacies (112).”
Candio, P., & Ooms, T. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13696-4 · Cited by 7 · see citing works
“These studies ranged markedly in scope, with three focusing on type II diabetes management [27, 42, 43] one in atopic dermatitis [44], one in acute stroke [45] and one on cardiovascular conditions in rural areas [46].”
InfluentialA Systematic Review of Telehealth Applications in Endocrinology
SeyedAlinaghi, S., Yarmohammadi, S., Mirzapour, P., Dehghani, S., Ahmadi, S., Abbaspour, F., Pashaei, A., Molla, A., Pashaei, A., Ahmadi, S., et al. (2024) · Telemedicine Reports · doi:10.1089/tmr.2024.0032 · Cited by 6 · see citing works
“13,14 The increasing cost of health care and the need for enhanced treatment options are prompting more hospitals to explore the advantages of telemedicine.”
Ehrhardt, N. M., Cedeno, B., Montour, L., Sinclair, K., Ferguson, G., Berberian, P., Comstock, B. A., & Wright, L. A.-C. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-082005 · Cited by 7 · see citing works
“7 8 Tele-medicine is often underused in populations such as those that identify as Latinx, 31–33 as digital literacy and access to broadband internet are barriers that contribute to health inequalities in this population.”
BackgroundAldakhil, R., Greenfield, G., Lammila-Escalera, E., Laranjo, L., Hayhoe, B., Majeed, A., & Neves, A. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251316585 · Cited by 5 · see citing works
“78 While none of the studies definitively conclude that VCs have worsened existing disparities compared with face-to-face, they all highlight the risk of exacerbating these inequities if the challenges faced by older and less digitally literate populations are not adequately addressed.”
UNDERWOOD, P. C., Ruscitti, B., Nguyen, T. H., Magny‐Normilus, C., Wentzell, K., Watts, S. A., & H, D. B. M. P. (2025) · Health Systems & Reform · doi:10.1080/23288604.2025.2503648 · Cited by 7 · see citing works
“18,19 In addition, clinical studies and systematic literature reviews demonstrate the success of both DPP and DSME interventions on diabetes clinical outcomes including lower hemoglobin A1c (HbA1c), lowering BMI, and improving medication adherence 12,20–26 Despite the demonstrated effectiveness of…”
Giallauria, F., Baratta, R., Costa, F., D’Amario, D., Gennaro, L. D., Giubilato, S., Mattina, A., Provenzano, M., Santoro, D., & Versaci, F. (2022) · Minerva Medica · doi:10.23736/s0026-4806.22.08165-4 · Cited by 5 · see citing works
Mapping Barriers and Interventions to Diabetes Self-Management in Latino Youth: A Scoping Review
de Lucca, M., de Visser, M., André, T. G., LETURIA, S. M. N., Nascimento, L. C., & Banca, R. O. L. (2025) · Children · doi:10.3390/children12070882 · Cited by 5 · see citing works
Telehealth Uptake Among Hispanic People During COVID-19: Retrospective Observational Study
Shang, D., Williams, C., & Culiqi, H. (2024) · JMIR Medical Informatics · doi:10.2196/57717 · Cited by 4 · see citing works
“The lack of internet access exacerbates the inequity in service access [18].”
Philis‐Tsimikas, A., Fortmann, A. L., Clark, T. L., Bagsic, S. R. S., Farcas, E., Roesch, S. C., SCHULTZ, J. H., Gilmer, T., Godino, J., Savin, K. L., et al. (2024) · Annals of Behavioral Medicine · doi:10.1093/abm/kaae077 · Cited by 5 · see citing works
Mental Health Utilization Among Transgender Veterans
Lee, J. L.-Y., Hirsh, A. T., Radhakrishnan, A., Jasuja, G. K., Taylor, S., Dickinson, S., Mineo, J., Carnahan, J. L., & Weiner, M. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.54694 · Cited by 4 · see citing works
Artificial Intelligence in Personalized Medicine for Diabetes Mellitus: A Narrative Review
Ghosh, K., Chandra, S., Ghosh, S., & Ghosh, U. S. (2025) · Cureus · doi:10.7759/cureus.91520 · Cited by 4 · see citing works
Health Impact of a Mobile-Delivered Diabetes Intervention to Control Blood Pressure in Older Adults
Goodman, K. S., & Locke, E. R. (2024) · AJPM Focus · doi:10.1016/j.focus.2024.100244 · Cited by 3 · see citing works
“22,23,28 During the coronavirus disease 2019 (COVID-19) pandemic, telehealth reduced barriers normally associated with access to care.”
BackgroundResultInfluentialPekmezaris, R., Martinez, S., Gomez, V. C., Marino, J., Goris, N., Williams, M. S., Cigaran, E., Nouryan, C. N., Patel, V. H., Myers, A. K., et al. (2024) · Clinical Diabetes · doi:10.2337/cd24-0002 · Cited by 3 · see citing works
da Costa, M. V. G., Zandonadi, R. P., Ginani, V. C., Funghetto, S. S., de Lima, L. R., Rehem, T. C. M. S. B., & Stival, M. M. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22020282 · Cited by 3 · see citing works
“Several types of educational technologies have been used to achieve better glycemic control in people diagnosed with DM [17–21].”
Walker, B., Stoecker, C., Shao, Y., Nauman, E., Kabagambe, E. K., & Shi, L. (2023) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2022.0509 · Cited by 3 · see citing works
“22 23–26 In this study, we examined how observable covariates such as race and ethnicity were differently associated with the uptake of telehealth services among Medicare patients with type 2 diabetes mellitus (T2DM) in Louisiana.”
Effects of Multilevel and Multidomain Interventions on Glycemic Control in U.S. Hispanic Populations
Bianco, L. D., Uranga, S. I., Rodriguez, A. W., SHETTY, R., Staab, E. M., Franco, M. I., Deckard, A. N., Thomas, N. C., Wan, W., Alexander, J. T., et al. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22091345 · Cited by 2 · see citing works
“One systematic review and meta-analysis of interventions that utilized telehealth for Black and Hispanic patients aimed to compare effects by level of intervention, but the authors identified only two studies that addressed any level beyond the individual patient [10].”
The Effectiveness of Telenursing for Diabetes Self-management Education: A Scoping Review
Marlina, T. T., Haryani, H., Widyawati, W., & Febriani, D. H. (2023) · The Open Nursing Journal · doi:10.2174/18744346-v17-230815-2023-38 · Cited by 5 · see citing works
Sathe, N. A., Ovelman, C., Ospina, N. S., Dewidar, O., Terhune, E., Francis, D., Welch, V. A., Heyn, P. C., Duque, T. G., & Viswanathan, M. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4735939 · Cited by 2 · see citing works
Barriers and Facilitators to Video Telehealth Use in Low-Income Hispanic Patients
Peterson, D. J., de Haro, C. M., Kilgore, D. B., Sorkin, D. H., Gago–Masague, S., & Billimek, J. (2025) · Family & Community Health · doi:10.1097/fch.0000000000000430 · Cited by 1 · see citing works
A Community-Partnered Approach to Address Excess Type 2 Diabetes Mellitus in a Midwestern Community
Enriquez, M., Molina, R., Alvarez, N., Barbosa, M., Cheng, A.-L., Collette, J., Kelly, P. J., Luna, D., Mora, W., Mourad, W., et al. (2025) · Journal of Community Health Nursing · doi:10.1080/07370016.2025.2522172 · Cited by 1 · see citing works
“Another recent review of telehealth interventions found positive outcomes; however, participants were recruited from clinical practices, so they were already engaged in care (Anderson et al., 2022).”
Telehealth as a Window into the Future: Ethical Lessons for AI in Healthcare
Palmer, A., & Masciari, C. F. (2025) · The International Library of Bioethics · doi:10.1007/978-3-031-94690-5_5 · Cited by 1 · see citing works
Tucker, C. M., Wippold, G. M., Anton, S. D., Klein, K. G., Lee, J., Li, D. M., Mitchell, D. A., Knight, A.-M., Stewart, E. B., & Garcia, K. A. (2025) · Patient Education and Counseling · doi:10.1016/j.pec.2025.109334 · Cited by 1 · see citing works
Gracia, C. R., Flyckt, R. L., Brooks, M., Hill, M. J., Jain, T., Sakkas, D., Pier, B. D., Steiner, A. Z., Anderson, J., Tanrikut, C., et al. (2025) · Fertility and Sterility · doi:10.1016/j.fertnstert.2025.08.003 · Cited by 1 · see citing works
Joshi, M., Kim, K., Pickard, A. S., Sharp, L. K., Gerber, B. S., & Touchette, D. R. (2025) · American Journal of Health-System Pharmacy · doi:10.1093/ajhp/zxaf318 · Cited by 1 · see citing works
The Use of Diabetes Technology in Persons with Diabetes and Coronavirus 2019
Szmuilowicz, E. D., & Aleppo, G. (2023) · Contemporary Endocrinology · doi:10.1007/978-3-031-28536-3_11
Eriyani, T., Mulyana, A. M., Pebrianti, S., Shalahuddin, I., & Fernanda, N. P. M. (2023) · Malaysian Journal of Medicine and Health Sciences · doi:10.47836/mjmhs.19.5.42
Shang, D., & Williams, C. (2023) · Hawaii International Conference on System Sciences (HICSS) · doi:10.24251/hicss.2023.391
Shang, D., Williams, C., & Culiqi, H. (2024) · doi:10.2196/preprints.57717
Quach, H. T., Võ, T. H. H., & Nguyễn, T. M. L. (2024) · Vietnam Journal of Diabetes and Endocrinology · doi:10.47122/vjde.2023.65.2
Diabetes Education via Telehealth
Seley, J. J., & Jack, G. A. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-13244-5.00006-7
Perceptions of telehealth use by PAs post-COVID-19
Raspet, E., & Gietzen, L. (2024) · JAAPA · doi:10.1097/01.jaa.0000000000000060
“1,4 providing care via telehealth, which can be addressed through increased use and training.”
Dear Health Care Professional: What People Need and Want When Diagnosed With Type 2 Diabetes
Boakye, M. D. S., Miyamoto, S., Greenwood, D. A., Boltz, M. P., Kraschnewski, J. L., & Haitsma, K. S. V. (2024) · Clinical Diabetes · doi:10.2337/cd23-0105
Egede, L. E., Williams, J. S., Knapp, R. G., & Walker, R. J. (2025) · Journal of General Internal Medicine · doi:10.1007/s11606-025-09883-y
“16–20 This study tested the combination of two effective strategies for improving metabolic control – diabetes education and skills training and technology – in comparison to a true usual care group.”
Factors Associated With Minorities’ Use of Telehealth During COVID-19
Miller, E., Harris, A., Abu-Alhaija, D. M., Okour, A., & Bakas, T. (2025) · Western Journal of Nursing Research · doi:10.1177/01939459251386264
A CFIR-guided qualitative study of digital health engagement among Black adults with type 2 diabetes
Zein, A. E., Hays, D., Glidden, G., Johnson, S., John, T., Nawshin, T., Hearld, L. R., & Mehta, T. S. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-02107-x
“Black adults are oftenunderrepresentedintelehealthstudies 9 ,andlittleisknownabouttheir lived experiences engaging with digital health tools, especially in low-resource settings where structural barriers may limit uptake.”
Iloanusi, C. A., Barman, M., Ahmed, M. F., Arefine, R., & Muna, M. K. (2026) · Future Health · doi:10.25259/fh_2_2025
Telemedicine and Remote Patient Monitoring Solutions
Lodge, A., & Guo, R. (2026) · Health informatics · doi:10.1007/978-3-032-23933-4_9
Bravo, R. J., Owsley, K. M., Longo, M. T., Shi, L., Hidalgo, B., & Walker, B. (2026) · Telemedicine Journal and e-Health · doi:10.1177/15305627261450303
Himmelfarb, C. D., Chepkorir, J., Miller, H., Ogungbe, O., Perrin, N., Olawole, W., Cain, G. E., Kinlock, B. L., Mullins, C. D., Kutcherman, I., et al. (2026) · medRxiv · doi:10.64898/2026.05.26.26354175
“11,12 As a result, empirical guidance remains limited on how to effectively integrate digital tools and community health worker (CHW)-led approaches within existing community infrastructures to promote scalable and sustainable cardiometabolic disease prevention and management.”
Racial Differences in Breast Cancer Treatment and Information Access
Williams, T., Li, M. X., Fine, K. S., Melnick, B. A., Ho, K. C., Joseph, J., Allums, J., Fuentes, R. J. C., Coles, B. M., & Galiano, R. D. (2026) · Journal of Surgical Oncology · doi:10.1002/jso.70304
Approaches to Diabetes Self-Management Education in Europe: An Extensive Literature Review
Borsoi, L., Falivena, C., & Callea, G. (2026) · Clinical Therapeutics · doi:10.1016/j.clinthera.2026.07.014
Chaudhary, V., Sharma, B., Kumari, S., Atem, T. D., Babu, M. M. H., Murti, K., Kumar, N., & Pal, B. (2026) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2026.102470
Singh, N., Buderer, N. M. F., & Langford, A. T. (2026) · Digital Health · doi:10.1177/20552076261491086
- Authors
- Anderson, A., O’Connell, S. S., Thomas, C., & Chimmanamada, R.
- Affiliations
- Tulane University (US)
- Corresponding author
- Anderson, Andrew
- Venue
- Journal of Racial and Ethnic Health Disparities
- Published
- 2022-01-09
- Volume
- 9
- Issue
- 6
- Pages
- 2375-2386
- ISSN
- 2196-8837 (ISSN-L)
- 2197-3792
- PMC
- PMC8742712
- OpenAlex
- W4205580653
- Cited by
- 70
- References
- 55
- Citations by year
- 2026: 8 · 2025: 24 · 2024: 16 · 2023: 17 · 2022: 5
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Racial and Ethnic Health Disparities (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- telemedicine, diabetes management, glycemic control, HbA1c, Black patients, Hispanic patients, racial and ethnic minorities, diabetes self-management education, health disparities, health care access, virtual visits
- MeSH terms
- Diabetes Mellitus, Ethnicity, Glycated Hemoglobin, Hispanic or Latino, Humans, Minority Groups, Telemedicine
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