Acceptability and Feasibility of Implementing a Telehealth Kit for Older Adults with Diabetes in an FQHC Clinic.

Background: Telehealth-supported diabetes monitoring may improve diabetes monitoring for older adults who experience barriers to traditional in-person care, but less is known about the acceptability and feasibility of telehealth-supported diabetes management in Federally Qualified Health Center (FQHC) settings. This pre-post quasi-experimental study examined the acceptability and feasibility of implementing a telehealth kit to support diabetes monitoring among adults aged 50 years and older receiving care at an FQHC clinic. Methods: This single-group pilot feasibility study enrolled adults aged 50 years and older with diabetes who received a telehealth kit that included a Bluetooth-enabled glucometer, blood pressure monitor, testing supplies, written instructions, and in-person training. No randomization or comparator group was used, and the study was not designed to test the efficacy of a new diabetes treatment. Quantitative surveys and glucose data were collected at baseline, 30 days, and 60 days to describe feasibility indicators and exploratory glucose trends. Qualitative open-ended responses were collected at baseline and follow-up visits and analyzed using rapid thematic analysis to identify barriers and facilitators to telehealth engagement. Results: Thirty participants completed the study. Participants were predominantly female (60.0%) and Non-Hispanic Black (66.7%); all reported smartphone and internet access, and most reported medium-high or high digital confidence. Mean glucose values remained relatively stable from baseline to 30 and 60 days, with overall means of 122.7, 127.9, and 117.4, respectively. Participants younger than 65 years experienced a significant reduction in glucose at 60 days compared with those aged 65 years and older. No significant differences in glucose change were observed by education, digital confidence, or medication adherence. Qualitative findings identified four themes: acceptability and usefulness of the telehealth platform over time; platform usability and authentication barriers; the role of digital literacy and support systems in participation; and contextual and infrastructural barriers beyond platform usability. Conclusions: Telehealth-supported diabetes monitoring was acceptable and feasible for some older adults receiving care in an FQHC setting, but engagement was conditional on reliable connectivity, usable platform design, successful authentication, and ongoing support. Findings suggest that future feasibility and implementation in medically underserved settings should incorporate simplified technology workflows, structured onboarding, technical assistance, and, when appropriate, family or caregiver support.