Literature Review & Evidence Matrix Assignment
For this literature review and Evidence matrix assignment, you will prepare a 3 to a 4-page review of the literature pertinent to a selected problem for healthcare research and to use that review to propose a methodology to address the problem.
- A. Conduct a search of literature relevant to the problem/topic. Identify a minimum of 4 references, most of which are peer-reviewed articles. Only one opinion articles may be included.
- B. Read the peer-reviewed articles with the focus of preparing a document that will compare and contrast the information in the articles you found. Copies of the articles used must be submitted with the final paper.
- C. The reader of your literature review should be able to clearly identify the gaps in the knowledge in the problem area as well as the purpose of the study you are proposing. The number of pages in this assignment should be no longer than 4 pages. You should be able to write enough to create an effective argument but not so much that the result looks padded.
- D. Prepare an Evidence Matrix using the template located in Module 2: Lecture Materials & Resources (https://stu.instructure.com/courses/43902/pages/module-2-lecture-materials-and-resources) .
Evidence Matrix Submission Instructions:
The introduction is original work and logically organized.
The paper is 3-4 pages in length and follows current APA format including citation of references.
Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
Your submission will be reviewed for plagiarism through Turnitin.
Complete and submit the assignment by 11:59 PM ET on Sunday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
SAMPLE ANSWER
Literature Review
Underserved populations experience higher rates of Type 2 Diabetes Mellitus (T2DM) due to insufficient healthcare access, minimal health literacy, and economic hurdles. These barriers result in inadequate disease management, leading to inferior health outcomes. The delivery of medical care through telehealth provides an alternative to traditional face-to-face (F2F) services, making chronic condition management, including T2DM, more accessible. This research review analyzes the success of telehealth interventions for T2DM management within underserved communities by examining current peer-reviewed research and identifying knowledge gaps. The review lays the foundation for creating a research methodology.
Summary of Literature
Mitchell et al. (2023) conducted a noninferiority randomized clinical trial to assess the effectiveness of immersive telemedicine for delivering Diabetes Medical Group Visits (DMGVs) to African American and Latina women with uncontrolled T2DM. Participants gathered through a virtual world platform for eight weeks. The findings showed that immersive telemedicine provided equivalent results to directly scheduled appointments in lowering HbA1c measurements. Both groups showed similar improvements in glycemic control and decreased diabetes distress, although physical activity did not significantly improve in either group. Ndungu et al. (2025) presented a scoping review on the use of Continuous Glucose Monitoring (CGM) in low-income T2DM patients. Although not a telemedicine intervention per se, CGM involves remote health data transmission, aligning with telehealth concepts. The review synthesized 15 studies and found consistent evidence that CGM reduced HbA1c and hypoglycemia incidents, even in resource-limited settings. However, the limited number of robust studies and uneven data across locations indicated a need for more comprehensive research.
A retrospective analysis by Ward (2023a) evaluated Electronic Health Records (EHRs) from an urban medically underserved population area (UMUPA), examining telemedicine utilization patterns across demographic groups. Key findings included that patients with uncontrolled diabetes were more likely to use telehealth compared to those with prediabetes. White patients and those aged 20–49 were also more likely to engage in telemedicine visits than older or Black patients. This study highlights disparities in telemedicine adoption and suggests that systemic and technological barriers may exist for certain demographic groups within underserved populations. Ward et al. (2023) conducted a retrospective study comparing telemedicine and F2F visits in T2DM patients within UMUPAs. Using multiple linear regression, they found that telemedicine users had a statistically significant reduction in HbA1c levels compared to those receiving F2F care (B = -0.339, p < 0.001). This suggests telehealth can be an effective alternative in managing blood glucose levels. However, this study also emphasized the need for user-friendly and accessible telemedicine platforms tailored to underserved populations.
Comparison and Contrast of Finding
All four articles agree on one central point: telehealth and related technologies can effectively support T2DM management in underserved populations. Mitchell et al. (2023) and Ward et al. (2023) provide direct comparisons showing that remote interventions are either equally effective or superior to traditional methods. Meanwhile, Ndungu et al. (2025) focus on the technological component—CGM—and its benefits even without real-time clinician interaction, while highlighting that socioeconomic factors hinder access and adoption. Where the studies differ is in their methodologies and populations. Mitchell et al. conducted a controlled clinical trial with a specific female minority cohort, while the Ward studies used retrospective data from broader patient groups. Moreover, Ward, Shah, and Waterfield (2023) add demographic complexity by showing that access to and utilization of telehealth are not uniform. This disparity presents an opportunity for further exploration and action.
Identified Gaps in the Literature
Several gaps in the current literature are evident from the comparative analysis. Most studies, including Mitchell et al. (2023), assess outcomes within six months, lacking data on long-term glycemic control and diabetes-related complications. Access disparities remain a concern, as highlighted by Ward et al. (2023) and Ward, Shah, and Waterfield (2023), who report racial, age-related, and technological literacy barriers in telehealth utilization. Standardized telehealth intervention practices concerning their type, frequency, and content would enable meaningful comparative analysis. According to Ndungu et al. (2025), integrating continuous glucose monitoring (CGM) technology into telehealth programs for underserved populations remains constrained.
Proposed Methodology
The research investigates the long-term operational success and accessibility of a telehealth system that combines virtual visits and continuous glucose monitoring technology for underserved adults with type 2 diabetes mellitus to achieve better glycemic control. The study design consists of a 12-month randomized controlled trial implemented at two Federally Qualified Health Centers that serve low-income urban communities. The research will enroll T2DM patients aged 18 years or older with HbA1c values of 8% or above living in underserved areas per HRSA standards. The study excludes potential participants who are pregnant and those diagnosed with type 1 diabetes. The intervention group participants will benefit from telehealth visits with nurse educators and endocrinologists once per month. They can access mobile apps with culturally adapted educational materials and use CGM devices to share real-time data. The control group will receive standard in-person diabetes care. Primary outcomes include changes in HbA1c over 12 months, while secondary outcomes include hospitalization rates, hypoglycemia episodes, CGM adherence, quality of life, and patient satisfaction. Data will be collected quarterly and analyzed using independent t-tests, repeated measures ANOVA, logistic regression, and thematic analysis of focus group discussions to identify telehealth barriers and facilitators.
Conclusion
The existing literature demonstrates that telehealth can be as effective as in-person care for managing T2DM in underserved populations, though access disparities remain a concern. CGM offers additional benefits but is underused. The proposed study aims to build on this foundation by integrating telehealth with CGM in a standardized, culturally responsive model to assess long-term outcomes and usability. Addressing these gaps is essential to achieving health equity in diabetes care.
References
Mitchell, S. E., Bragg, A., De La Cruz, B. A., Winter, M. R., Reichert, M. J., Laird, L. D., … & Gardiner, P. (2023). Effectiveness of an immersive telemedicine platform for delivering diabetes medical group visits for African American, Black and Hispanic, or Latina women with uncontrolled diabetes: the women in control 2.0 noninferiority randomized clinical trial. Journal of medical Internet research, 25, e43669. https://doi.org/10.2196/43669
Ndungu, M., Babalola, R. O., Brand, M., & Patel, R. (2025). Impact of continuous glucose monitoring in underserved adults with type 2 diabetes within the United States: A scoping review. Journal of the American College of Clinical Pharmacy, 8(2), 149-162. https://doi.org/10.1002/jac5.2078
Ward, L. A., Shah, G. H., Jones, J. A., Kimsey, L., & Samawi, H. (2023). Effectiveness of telemedicine in diabetes management: A retrospective study in an urban medically underserved population area (umupa). In Informatics (Vol. 10, No. 1, p. 16). MDPI. https://doi.org/10.3390/informatics10010016
Evidence Matrix Table
| Author | Journal Name/ Year of Publication | Research Design | Sample Size | Outcome Variables Measured | Quality (A, B, C) | Results/Author’s Suggested Conclusion |
| Mitchell et al. | Journal of Medical Internet Research / 2023 | Noninferiority Randomized Controlled Trial | 309 adult women | Hemoglobin A1c (HbA1c), physical activity (MET-hours), diabetes distress, depressive symptoms | A | Immersive telemedicine was noninferior to in-person diabetes medical group visits in improving HbA1c and reducing diabetes distress and depression; physical activity did not improve. |
| Ndungu et al. | Journal of the American College of Clinical Pharmacy / 2025 | Scoping Review | 15 studies | Hemoglobin A1c levels, hypoglycemia incidence, glucose control, time in range | B | CGM improved glycemic outcomes (A1C, hypoglycemia, time in range) among low-income adults with T2DM. More research is needed to address access barriers and promote equity. |
| Ward et al. | BioMedInformatics/2023 | Retrospective Cohort Study with Logistic Regression | 265 patients (3357 appointments) | Mode of care (Telemedicine vs. Face-to-Face), diabetes stage, age, race, gender | B | Telemedicine was more used by patients with uncontrolled diabetes. Older adults and Black patients were less likely to use telemedicine. Telemedicine should be adapted for equitable access. |
| Ward et al. | Informatics/2023 | Retrospective Study with Multiple Linear Regression | Not specified (EHR data from 1/2019–6/2021) | HbA1c levels, type of care (TM vs. F2F), age, gender, race | B | Telemedicine use was associated with significantly lower HbA1c levels. Age was negatively correlated with HbA1c. Female and Black patients had higher HbA1c levels. TM is effective for diabetes care in underserved areas. |
References
Mitchell, S. E., Bragg, A., De La Cruz, B. A., Winter, M. R., Reichert, M. J., Laird, L. D., … & Gardiner, P. (2023). Effectiveness of an immersive telemedicine platform for delivering diabetes medical group visits for African American, Black and Hispanic, or Latina women with uncontrolled diabetes: the women in control 2.0 noninferiority randomized clinical trial. Journal of medical Internet research, 25, e43669. https://doi.org/10.2196/43669
Ndungu, M., Babalola, R. O., Brand, M., & Patel, R. (2025). Impact of continuous glucose monitoring in underserved adults with type 2 diabetes within the United States: A scoping review. Journal of the American College of Clinical Pharmacy, 8(2), 149-162. https://doi.org/10.1002/jac5.2078
Ward, L. A., Shah, G. H., Jones, J. A., Kimsey, L., & Samawi, H. (2023). Effectiveness of telemedicine in diabetes management: A retrospective study in an urban medically underserved population area (umupa). In Informatics (Vol. 10, No. 1, p. 16). MDPI. https://doi.org/10.3390/informatics10010016
Jermaine Byrant
Nicole Johnson
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