Background: The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites the 7 medical schools in Ohio to improve cardiovascular (CV) and diabetes health outcomes and eliminate disparities in Ohio’s Medicaid population. The purpose of the Cardi-OH needs assessment was to identify high priority clinical topics for the dissemination of evidenced-based best practices to providers across the state. Methods: The cross-sectional survey was distributed via REDCap (research electronic data capture) to Cardi-OH members and its external contacts (i.e., people who have engaged with Cardi-OH but are not members) in 2022. Question topics were identified by Cardi-OH members based on perceived gaps in existing content. Results: A total of 88% (n=103) of 117 Cardi-OH members and 8% (n=98) of 1,204 external contacts participated. Of those, 51% (n=53) of Cardi-OH members and 47% (n=46) of external contacts provided direct clinical care. The top items for Cardi-OH members (clinical and non-clinical combined) were: 1) lifestyle prescriptions (n=50, 49%), 2) atypical diabetes (n=38, 37%), 3) COVID-19 and cardiovascular disease (CVD) (n=38, 37%), and 3) mental health and CVD (n=38, 37%). For external contacts, the top topics were: 1) lifestyle prescriptions (n=53, 54.1%), 2) mental health and CVD (n=39, 39.8%), 3) alcohol and CVD (n=27, 27.6%), and 3) CV complications (n=27, 27.6%). Regarding social determinants of health (SDOH), Cardi-OH members prioritized: 1) weight bias and stigma (n=44, 43%), 2) family-focused interventions (n=40, 39%), and 3) adverse childhood experiences (ACEs, n=37, 36%). External contacts selected: 1) family-focused interventions (n=51, 52%), 2) implicit bias (n=43, 43.9%), and 3) ACEs (n=39, 39.8%). Conclusions: Shared prioritized topics included lifestyle, SDOH, and behavioral health; these may be useful to other professional organizations as they consider dissemination priorities. Disclosure E.A.Beverly: None. A.Kinsella: None. L.J.Lammert: None. A.Nevar: None. G.Irwin: None. C.Rollins: None. M.W.Konstan: None. S.D.Bolen: None. S.Koopman gonzalez: Research Support; Bristol Myers Squibb Foundation. K.M.Dungan: Board Member; Elsevier, Consultant; Eli Lilly and Company, Dexcom, Inc., Other Relationship; UpToDate, Research Support; Dexcom, Inc., Abbott, ViaCyte, Inc., Sanofi, Speaker's Bureau; Academy for Continued Healthcare Learning, Cardiometabolic Health Congress, Medscape, Integritas. J.T.Wright: Advisory Panel; Medtronic. K.R.Baughman: None. R.Wexler: None. L.D.Dworkin: None. G.D.Solomon: None. J.F.Lamb: None. Funding Ohio Department of Medicaid’s Medicaid Technical Assistance and Policy Program

Background: Research on the diagnosis of diabetes portrays it as a functional process of adapting to the condition. People experience variations in physical and psychosocial responses to their diagnosis. No known research has compared diagnosis experiences between people with type 1 diabetes (T1D) and type 2 diabetes (T2D). The purpose of this study was to identify similarities and differences in T1D and T2D diagnosis stories. Methods: We conducted in-depth interviews with adults with T1D and T2D. Two researchers coded the interviews, met to resolve discrepancies, and agreed on themes using NVivo software. Results: A purposive sample of 48 adults participated (mean A1C=7.7±1.8%; mean duration=13.4±12.9 years, mean age=45.8±21.7 years). Nineteen (39.6%) reported a diagnosis of T1D and 29 (60.4%) reported a diagnosis of T2D. Qualitative analysis revealed three themes: 1) Similar Emotional Reactions to Diagnosis: Both participants with T1D and T2D expressed feelings of frustration, depression, fear, and denial in their diagnosis experiences. Interestingly, only T2D participants expressed worry for long-term complications, with some individuals equating their diagnosis to a “death sentence.” 2) Similar Experiences with Diagnosis as a Major Life Event: Both T1D and T2D participants described their diagnosis as a significant life event, with several noting that their life will never be the same. 3) Different Perceptions of Diagnosis as a Surprise: Participants with T1D described their diagnosis as a surprise, whereas participants with T2D did not. Those with T1D expressed initial feelings of denial, while those with T2D referred to their diabetes as inevitable. Conclusion: T1D and T2D participants shared similar emotional reactions, and both described their diagnosis as a major life event. Differently, T1D participants perceived their diagnosis as a surprise, while T2D participants expected their diagnosis. This information may assist clinicians in supporting people with diabetes at diagnosis. Disclosure A.M.Pugh: None. E.A.Beverly: None.

Nearly 80% of adults with diabetes report experiences of diabetes stigma, varying by the use of insulin therapy. We aimed to examine associations between diabetes stigma and the use of diabetes technologies among adults with insulin and non-insulin-treated type 2 diabetes (T2D). In August 2022, 947 adults with T2D (mean age: 64±11 years; duration T2D: 19±9 years; 62% women; 61% insulin-treated) from the dQ&A US Patient Panel completed an online survey. Questions included the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) and diabetes and demographic characteristics. DSAS-2 total and subscale (Treated Differently, Blame and Judgment, Self Stigma) scores were compared by device use (independent samples t-test), and separately by treatment (insulin vs. non-insulin). Individuals with non-insulin-treated T2D using (vs. not using) CGM reported more stigma (Total; Treated Differently; Blame & Judgment) but did not differ on Self Stigma (Table). Stigma did not differ by device use among participants on insulin treatment, but was higher overall than those on non-insulin treatment. Further research is needed to understand how the experience of diabetes stigma may be affected by the visibility of T2D, specifically via diabetes technologies. Disclosure M.Garza: Other Relationship; Sanofi. E.Shoger: Other Relationship; Dexcom, Inc., Abbott Diabetes, Tandem Diabetes Care, Inc., Beta Bionics, Inc., Xeris Pharmaceuticals, Inc., MannKind Corporation. E.Holmes-truscott: Research Support; Sanofi, AstraZeneca. K.Joiner: None. A.Addala: None. D.Naranjo: None. E.A.Beverly: None. J.Speight: Research Support; Sanofi, Medtronic, Abbott Diabetes, Lilly, Novo Nordisk A/S, Speaker's Bureau; Sanofi.

Nearly 80% of adults living with diabetes report experiences of diabetes stigma. We aimed to examine associations between diabetes stigma and the use of diabetes technologies among adults with type 1 diabetes (T1D). In August 2022, 594 adults with T1D (mean age: 55±15 years; duration T1D: 29±17 years; 71% women) from the dQ&A US Patient Panel completed an online survey. Questions included the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) and diabetes and demographic characteristics. DSAS-1 Total and subscale (Treated Differently, Blame and Judgment, Identity Concerns) scores were compared by device use (independent samples t-test). Individuals who did not use diabetes technologies reported greater stigma (Total; Treated Differently; Identity Concerns) but did not differ from those using technologies on Blame and Judgment (Table). The relationship between diabetes stigma and technology use is a novel finding, warranting further investigation with larger, more heterogeneous samples to determine whether diabetes stigma may be a barrier to device use or whether it is mitigated by device use. Disclosure M.Garza: Other Relationship; Sanofi. E.Shoger: Other Relationship; Dexcom, Inc., Abbott Diabetes, Tandem Diabetes Care, Inc., Beta Bionics, Inc., Xeris Pharmaceuticals, Inc., MannKind Corporation. E.Holmes-truscott: Research Support; Sanofi, AstraZeneca. K.Joiner: None. A.Addala: None. D.Naranjo: None. E.A.Beverly: None. J.Speight: Research Support; Sanofi, Medtronic, Abbott Diabetes, Lilly, Novo Nordisk A/S, Speaker's Bureau; Sanofi.

Background: Virtual reality (VR) is a major driving factor in the growth of the medical education market. VR simulates objects, places, and interactions in a 3D multimedia sensory environment. Research shows its effectiveness in surgical training, anatomy, and role-playing in clinical encounters. However, minimal research has compared the effectiveness of different delivery modes. The purpose of this study was to compare fully-immersive and semi-immersive VR in diabetes training. Methods: In this quasi-experimental study, healthcare trainees participated in either a fully-immersive 360-degree VR training with head-mounted displays (prior to SARS-CoV-2 pandemic) or a semi-immersive online VR training (during pandemic) . Participants completed the Diabetes Attitude Scale-3, Jefferson Scale of Empathy, and Transcultural Self-Efficacy Tool pre- and post-training. We conducted paired t-tests and independent t-tests with mean change scores for each measure to examine differences between study arms. Results: A total of 115 trainees participated (22.0±3.7 years, 82.6% women, 79.1% White, 24.3% medical students) . Participants in the fully-immersive VR arm (n=69) showed improvements in all diabetes attitude subscales, empathy, and all cultural self-efficacy subscales. Participants in the semi-immersive arm (n=46) showed improvements in all diabetes attitude subscales and two of the three cultural self-efficacy subscales, but not empathy (t=1.360, p=.182) or affective cultural self-efficacy (t= -1.798, p=.081) . Comparisons between fully-immersive and semi-immersive VR revealed no differences in diabetes attitudes or cultural self-efficacy; however, the fully-immersive VR showed greater improvements in empathy (t= -4.325, p<.001) . Conclusion: Our findings suggest fully-immersive VR is more effective in improving empathy than semi-immersive VR training. Future research should use a randomized-control design to compare the two delivery modes and examine the measures over time. Disclosure E.A.Beverly: None. M.Love: None. C.Love: None.