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The National Diabetes Prevention Program (NDPP) offers lifestyle change education to adults at risk for diabetes across the United States, but its reach is curbed due, in part, to limitations of traditional in-person programs. Diabetes Prevention Programs (DPPs) that are fully digital may increase reach by overcoming these barriers. The aim of this research was to examine the reach of Lark's DPP, a fully digital artificial-intelligence-powered DPP. This study assessed geographic features and demographic characteristics of a sample of Lark DPP commercial health plan members with complete data ( N  = 16,327) and compared several demographic features with a large composite sample of members from DPPs across the nation (NDPP; N  = 143,489) and a National Health Interview Survey (NHIS) sample of prediabetic adults in the United States (NHIS; N  = 2118). Examination of the Lark DPP sample revealed that 24.4% of members lived in rural areas, 30.8% lived in whole county health professional shortage areas, and only 7.6% of members lived in a zip code with an in-person DPP. When comparing the Lark sample with the NDPP and NHIS samples, Lark DPP enrollees tended to be younger and have a higher body mass index (BMI) ( p' s < 0.001). Lark provides convenient access to a DPP for individuals living in hard-to-reach areas who may face barriers to participating in in-person or telephonic DPPs or who prefer a digital program. Compared with the NDPP sample, Lark is also reaching younger and higher BMI users, who are traditionally difficult to enroll and have a high need for intervention.

Background: Providing quality, current cancer information to cancer patients and their families is a key function of the National Cancer Institute (NCI) Web site. This information is now provided in predominantly-text format, but could be provided in formats using multimedia, including animation and sound. Since users have many choices about where to get their information, it is important to provide the information in a format that is helpful and that they prefer., Objective: To pilot and evaluate multimedia strategies for future cancer-information program formats for lay users, the National Cancer Institute created new multimedia versions of existing text programs. We sought to evaluate user performance and preference on these 3 new formats and on the 2 existing text formats., Methods: The National Cancer Institute's "What You Need to Know About Lung Cancer" program was the test vehicle. There were 5 testing sessions, 1 dedicated to each format. Each session lasted about 1 hour, with 9 participants per session and 45 users overall. Users were exposed to the assigned cancer program from beginning to end in 1 of 5 formats: text paperback booklet, paperback booklet formatted in HTML on the Web, spoken audio alone, spoken audio synchronized with a text Web page, and Flash multimedia (animation, spoken audio, and text). Immediately thereafter, the features and design of the 4 alternative formats were demonstrated in detail. A multiple-choice pre-test and post-test quiz on the cancer content was used to assess user learning (performance) before and after experiencing the assigned program. The quiz was administered using an Authorware software interface writing to an Access database. Users were asked to rank from 1 to 5 their preference for the 5 program formats, and provide structured and open-ended comments about usability of the 5 formats., Results: Significant improvement in scores from pre-test to post-test was seen for the total study population. Average scores for users in each of the 5 format groups improved significantly. Increments in improvement, however, were not statistically different between any of the format groups. Significant improvements in quiz scores were seen irrespective of age group or education level. Of the users, 71.1% ranked the Flash program first among the 5 formats, and 84.4% rated Flash as their first or second choice. Audio was the least-preferred format, ranking fifth among 46.7% of users and first among none. Flash was ranked first among users regardless of education level, age group, or format group to which the user was assigned., Conclusions: Under the pilot study conditions, users overwhelmingly preferred the Flash format to the other 4 formats. Learning occurred equally in all formats. Use of multimedia should be considered as communication strategies are developed for updating cancer content and attracting new users.

Original Medicare does not provide complete coverage for its beneficiaries. Many people with Medicare need additional coverage to fill in those gaps. A Medicare supplemental insurance policy (Medigap) can provide your clients with extra benefits not covered by Medicare. In this brief we offer an overview of Medigap policies and advice on what your clients should consider when purchasing a plan.

Medicare currently does not provide outpatient prescription drug coverage. People with Medicare who do not have continuous prescription drug coverage face higher out-of-pocket expenditures and may not comply with their prescriptions in order to save money. This brief explores some of the issues facing beneficiaries without drug coverage and describes some of the different options available to help offset the costs of prescription medications.

Background: There are very limited data on cancer among U.S. Hispanics. The data that are available seldom appear outside individual registry reports. Without coalescing and assessing such information, the epidemiology of cancer among Hispanics cannot be understood., Purpose: This article presents an overall view of the epidemiology of cancer among Hispanic populations in the United States., Methods: Major types of cancer were reviewed from geographic areas with 1) large Hispanic/Latino populations and 2) population-based cancer registries that cover 68% of the U.S. Hispanic population. Age-standardized rates, standardized rate ratios, and ranks of the top cancers are presented for Hispanics and non-Hispanics by sex., Results: Hispanic men had consistently lower rates of cancers of the lung, prostate, colon, rectum, and oral cavity as well as of melanoma and non-Hodgkin's lymphoma than non-Hispanic men. Among Hispanic men, higher rates were observed for cancers of the stomach, liver, and gallbladder. Compared with the rates in non-Hispanic women, Hispanic women had consistently lower rates of cancers of the breast, colon, rectum, endometrium, lung, ovary, and oral cavity, non-Hodgkin's lymphoma, and melanoma and higher rates of cancers of the uterine cervix, stomach, liver, and gallbladder. Perhaps more importantly, however, was that, within U.S. Hispanic populations, the top five sites of cancer for women were breast, colon, lung, cervix, and uterine corpus. For men, the top sites were usually prostate, lung, colon, stomach, and rectum. Furthermore, some geographic areas showed differences in the order of importance within these five sites, while in other areas, the top five cancers for Hispanic men included kidney and bladder cancers, liver cancer, and non-Hodgkin's lymphomas. For women, other leading cancers mentioned were ovarian cancer, non-Hodgkin's lymphoma, and gallbladder cancer., Conclusions: Hispanics had consistently lower rates of breast, lung, prostate, and colon cancers than non-Hispanics. In some geographic regions, however, differences in cancer incidence rates with respect to specific sites existed between the heterogenous Hispanic populations. Furthermore, the rankings demonstrated that, even if Hispanics have lower rates of the most common cancers than non-Hispanics, such sites are still the most important cancers among Hispanic populations., Implications: Cancer is a major problem among U.S. Hispanic populations. The information given in this article can be used to develop etiologic studies and cancer control interventions. Data limitations and recommendations for improving data quality are presented.