Making Patient Contextual Data Concrete: Abstraction Hierarchy to Understand Patient Self-Management of Type 2 Diabetes

Social determinants of health (SDOH) and other contextual factors influence a patient’s ability to adhere to a plan of care. Providers must understand these factors in order to develop treatment plans which best meet patient needs and preferences. This is particularly important for patients with type 2 diabetes, which is primarily managed by the patient. Abstraction hierarchy is a modeling technique from the cognitive work analysis framework which describes system components at multiple levels of abstraction. This study seeks to examine SDOH as they relate to type 2 diabetes management by the patient and activities carried out by the primary care provider to incorporate these factors into the medical decision-making process. The abstraction hierarchy was developed based on previous literature and interviews with patients and primary care medical personnel. The resulting abstraction hierarchy can be used to inform future screening tools and patient-centered care interventions for addressing SDOH for patients with type 2 diabetes.