Addie L Fortmann1, Linda C Gallo2, Maria Isabel Garcia1, Mariam Taleb1, Johanna A Euyoque1, Taylor Clark1, Jessica Skidmore1, Monica Ruiz1, Sapna Dharkar-Surber3, James Schultz4, Athena Philis-Tsimikas5. 1. Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA. 2. Department of Psychology, San Diego State University, San Diego, CA tsimikas.athena@scrippshealth.org lgallo@mail.sdsu.edu jims@nhcare.org. 3. University of California, San Diego, San Diego, CA. 4. Neighborhood Healthcare, San Diego, CA tsimikas.athena@scrippshealth.org lgallo@mail.sdsu.edu jims@nhcare.org. 5. Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA tsimikas.athena@scrippshealth.org lgallo@mail.sdsu.edu jims@nhcare.org.
Abstract
OBJECTIVE: Type 2 diabetes is growing in epidemic proportions and disproportionately affects lower-income, diverse communities. Text messaging may provide one of the most rapid methods to overcome the "digital divide" to improve care. RESEARCH DESIGN AND METHODS: A randomized, nonblinded, parallel-groups clinical trial design allocated N = 126 low-income, Hispanic participants with poorly controlled type 2 diabetes to receive theDulce Digital intervention or usual care (UC). Dulce Digital participants received up to three motivational, educational, and/or call-to-action text messages per day over 6 months. The primary outcome was HbA1c; lipids, blood pressure, and BMI were secondary outcomes. Satisfaction and acceptability were evaluated via focus groups and self-report survey items. RESULTS: The majority of patients were middle-aged (mean age 48.43 years, SD 9.80), female (75%), born in Mexico (91%), and uninsured (75%) and reported less than a ninth-grade education level (73%) and mean baseline HbA1c 9.5% (80 mmol/mol), SD 1.3, and fasting plasma glucose 187.17 mg/dL, SD 64.75. A statistically significant time-by-group interaction effect indicated that the Dulce Digital group achieved a significantly greater reduction in HbA1c over time compared with UC (P = 0.03). No statistically significant effects were observed for secondary clinical indicators. The number of blood glucose values texted in by participants was a statistically significant predictor of month 6 HbA1c (P < 0.05). Satisfaction and acceptability ratings for the Dulce Digital intervention were high. CONCLUSIONS: Use of a simple, low-cost text messaging program was found to be highly acceptable in this sample of high-risk, Hispanic individuals with type 2 diabetes and resulted in greater improvement in glycemic control compared with UC.
RCT Entities:
OBJECTIVE:Type 2 diabetes is growing in epidemic proportions and disproportionately affects lower-income, diverse communities. Text messaging may provide one of the most rapid methods to overcome the "digital divide" to improve care. RESEARCH DESIGN AND METHODS: A randomized, nonblinded, parallel-groups clinical trial design allocated N = 126 low-income, Hispanic participants with poorly controlled type 2 diabetes to receive the Dulce Digital intervention or usual care (UC). Dulce Digital participants received up to three motivational, educational, and/or call-to-action text messages per day over 6 months. The primary outcome was HbA1c; lipids, blood pressure, and BMI were secondary outcomes. Satisfaction and acceptability were evaluated via focus groups and self-report survey items. RESULTS: The majority of patients were middle-aged (mean age 48.43 years, SD 9.80), female (75%), born in Mexico (91%), and uninsured (75%) and reported less than a ninth-grade education level (73%) and mean baseline HbA1c 9.5% (80 mmol/mol), SD 1.3, and fasting plasma glucose 187.17 mg/dL, SD 64.75. A statistically significant time-by-group interaction effect indicated that the Dulce Digital group achieved a significantly greater reduction in HbA1c over time compared with UC (P = 0.03). No statistically significant effects were observed for secondary clinical indicators. The number of blood glucose values texted in by participants was a statistically significant predictor of month 6 HbA1c (P < 0.05). Satisfaction and acceptability ratings for the Dulce Digital intervention were high. CONCLUSIONS: Use of a simple, low-cost text messaging program was found to be highly acceptable in this sample of high-risk, Hispanic individuals with type 2 diabetes and resulted in greater improvement in glycemic control compared with UC.
Authors: Silvio E Inzucchi; Richard M Bergenstal; John B Buse; Michaela Diamant; Ele Ferrannini; Michael Nauck; Anne L Peters; Apostolos Tsapas; Richard Wender; David R Matthews Journal: Diabetes Care Date: 2015-01 Impact factor: 19.112
Authors: Silvio E Inzucchi; Richard M Bergenstal; John B Buse; Michaela Diamant; Ele Ferrannini; Michael Nauck; Anne L Peters; Apostolos Tsapas; Richard Wender; David R Matthews Journal: Diabetes Care Date: 2012-04-19 Impact factor: 19.112
Authors: Taylor L Clark; Linda Gallo; Johanna A Euyoque; Athena Philis-Tsimikas; Addie Fortmann Journal: Diabetes Educ Date: 2020-03-31 Impact factor: 2.140
Authors: Lyndsay A Nelson; Robert A Greevy; Andrew Spieker; Kenneth A Wallston; Tom A Elasy; Sunil Kripalani; Chad Gentry; Erin M Bergner; Lauren M LeStourgeon; Sarah E Williamson; Lindsay S Mayberry Journal: Diabetes Care Date: 2020-11-05 Impact factor: 19.112