Tailoring Digital Technologies To Improve Outcomes Among Minorities With Chronic Conditions
Antoinette Schoenthaler, Ed.D.
Associate Director of the Center for Healthful Behavior Change
New York University Langone Health
“Funding from AHRQ has been instrumental in supporting the development of interventions to address the determinants of poor adherence to self-management behaviors. All three of my AHRQ-funded grants focus on placing patients’ voices at the center of self-managing their conditions to improve outcomes and mitigate inequities that drive poor health.”
Chronic conditions such as heart disease, diabetes, and stroke are the leading causes of disability and death in the United States. Interventions to support self-management behaviors among patients with chronic conditions are essential to improve health outcomes. Antoinette Schoenthaler, Ed.D., associate director of the Center for Healthful Behavior Change at New York University (NYU) Langone Health, has centered her research on examining the reasons for patients’ decisions to adhere to prescribed medicines and lifestyle behaviors, with a focus on minority patients. With AHRQ funding, Dr. Schoenthaler is developing digital healthcare solutions that meet the needs and preferences of patients with chronic conditions to facilitate better health outcomes. “I have always had a keen interest in understanding the factors that influence a person’s ability to manage their chronic condition in order to prevent downstream negative complications,” she said.
Many individuals are faced with obstacles, such as inadequate access to healthcare and other disparities, which prevent them from achieving their best health. This reality has prompted Dr. Schoenthaler, who also is an associate director of research at NYU’s Langone Institute for Excellence in Health Equity, to dedicate the past 20 years of her career to understanding and addressing these health barriers.
Dr. Schoenthaler began her AHRQ research journey in 2012 with a 3-year grant to evaluate whether healthcare technologies could provide support to community-based organizations that had limited resources for their efforts to monitor and manage high blood pressure.
Specifically, her project worked with lay health workers (LHWs) at three predominantly Black churches in New York City to implement a customized personal health record system. The system allowed LHWs to track blood pressure readings on web-based and congregation-specific dashboards, and helped them provide counseling and health education to motivate behavior change among those congregants with high blood pressure. Dr. Schoenthaler’s research not only improved the method used to track blood pressure readings, which originally were recorded on paper index cards, but her web-based platform helped LHWs see changes to blood pressure readings and behavior over a 9-month period for each congregation. Dr. Schoenthaler’s intervention helped community members lower their blood pressure and was pivotal in laying the foundation for automating, tracking, and meeting the needs of the participating organizations through their use of digital healthcare.
In 2018, Dr. Schoenthaler received a 5-year AHRQ grant to help patients better manage their Type 2 diabetes. She developed iMatter, a text messaging application that captures patient- reported outcomes (PROs) in real time. iMatter empowers patients to take an active role in their diabetes care and improve self-management behaviors by tracking personal information, such as diet, physical activity, medication adherence, and sleep quality. The application enables patients to receive and respond to PRO texts, receive motivational messages, and receive graphics of their PRO responses to share with their healthcare provider. Her study found that patients who used iMatter were more engaged in their diabetes care and improved their self-management behaviors.
Dr. Schoenthaler received another 5-year AHRQ grant in 2023 to expand on her previous iMatter project to improve outcomes for patients with Type 2 diabetes. iMatter2 will integrate features recommended by patients and providers who were interviewed for her initial project. For example, iMatter2 will incorporate artificial intelligence-supported tools, such as a virtual chatbox, to collect PROs and send patients personalized motivational and educational messages. It also will offer clinical decision support tools and behavioral 'nudging' to prompt providers to review the PRO data. This project is expected to end May 31, 2028.
Dr. Schoenthaler is a professor of Population Health and Medicine at NYU Grossman School of Medicine. She also is a member of the Partnership for Quality Measurement.
Principal Investigator: Antoinette Schoenthaler, Ed.D.
Institution: NYU Langone Health
Grantee Since: 2012
Type of Grant: Various
Related AHRQ Resources
- Blood Pressure Control Evidence and Resources
- Chronic Conditions
- Multiple Chronic Conditions
- Health IT and Digital Healthcare
Consistent with its mission, AHRQ provides a broad range of extramural research grants and contracts, research training, conference grants, and intramural research activities. AHRQ is committed to fostering the next generation of health services researchers who can focus on some of the most important challenges facing our Nation's health care system.
To learn more about AHRQ's Research Education and Training Programs, please visit https://www.ahrq.gov/training.
