Elizabeth Burner1, Chun Nok Lam1, Rebecca DeRoss1, Marjorie Kagawa-Singer2, Michael Menchine1, Sanjay Arora1. 1. 1 Department of Emergency Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California. 2. 2 Department of Community Health Sciences, University of California Los Angeles Jonathan and Karin Fielding School of Public Health , Los Angeles, California.
Abstract
BACKGROUND: Social support interventions can improve diabetes self-care, particularly for Latinos, but are time and resource intensive. Mobile health may overcome these barriers by engaging and training supporters remotely. METHODS: We conducted a randomized controlled feasibility trial of emergency department patients with diabetes to determine the feasibility of enrolling patients and supporters, acceptability of the intervention, and preliminary efficacy results to power a larger trial. All patients received an existing mHealth curriculum (TExT-MED). After identifying a supporter, patients were randomized to intervention: supporters receiving FANS (family and friends network support), a text message support curriculum synchronized to patient messages, or control: supporters receiving a mailed pamphlet of the same information. Participants followed up at 3 months. FANS intervention participants came to postintervention interviews as part of a qualitative analysis. RESULTS: We enrolled 44 patients (22 per arm) and followed up 36 at 3 months. Participants were positive about the program. FANS intervention improved HbA1c (intervention mean decreased from 10.4% to 9.0% vs. from 10.1% to 9.5%, delta -0.8%, confidence interval [CI] -0.4 to 2, P = 0.30), self-monitoring of glucose (intervention increased 1.6 days/week vs. control decreased 2 days/week, delta 2.3 days/week, CI 4-0.6, P = 0.02), and physical activity (mean Godin leisure time activity score improved 16.1 vs. decreased 9.6 for control, delta 25.7, CI 49.2-2.3, P = 0.10). In qualitative analysis, patients reported improved motivation, behaviors, and relationships. Supporters reported making healthier decisions for themselves. CONCLUSIONS: mHealth is a feasible, acceptable, and promising avenue to improve social support and diabetes outcomes.
BACKGROUND: Social support interventions can improve diabetes self-care, particularly for Latinos, but are time and resource intensive. Mobile health may overcome these barriers by engaging and training supporters remotely. METHODS: We conducted a randomized controlled feasibility trial of emergency department patients with diabetes to determine the feasibility of enrolling patients and supporters, acceptability of the intervention, and preliminary efficacy results to power a larger trial. All patients received an existing mHealth curriculum (TExT-MED). After identifying a supporter, patients were randomized to intervention: supporters receiving FANS (family and friends network support), a text message support curriculum synchronized to patient messages, or control: supporters receiving a mailed pamphlet of the same information. Participants followed up at 3 months. FANS intervention participants came to postintervention interviews as part of a qualitative analysis. RESULTS: We enrolled 44 patients (22 per arm) and followed up 36 at 3 months. Participants were positive about the program. FANS intervention improved HbA1c (intervention mean decreased from 10.4% to 9.0% vs. from 10.1% to 9.5%, delta -0.8%, confidence interval [CI] -0.4 to 2, P = 0.30), self-monitoring of glucose (intervention increased 1.6 days/week vs. control decreased 2 days/week, delta 2.3 days/week, CI 4-0.6, P = 0.02), and physical activity (mean Godin leisure time activity score improved 16.1 vs. decreased 9.6 for control, delta 25.7, CI 49.2-2.3, P = 0.10). In qualitative analysis, patients reported improved motivation, behaviors, and relationships. Supporters reported making healthier decisions for themselves. CONCLUSIONS: mHealth is a feasible, acceptable, and promising avenue to improve social support and diabetes outcomes.
Entities:
Keywords:
Diabetes mellitus; Disease management.; Latinos; Social support; Text messaging
Authors: Allison C Sylvetsky; Radha Nandagopal; Tammy T Nguyen; Marisa R Abegg; Mahathi Nagarur; Paul Kaplowitz; Kristina I Rother Journal: World J Diabetes Date: 2015-12-25
Authors: Mary Jane Rotheram-Borus; Mark Tomlinson; Margaret Gwegwe; W Scott Comulada; Neal Kaufman; Marion Keim Journal: Diabetes Educ Date: 2012-04-30 Impact factor: 2.140
Authors: Sanjay Arora; Kelsey Ford; Sophie Terp; Tiffany Abramson; Ryan Ruiz; Marissa Camilon; Christopher J Coyne; Chun Nok Lam; Michael Menchine; Elizabeth Burner Journal: J Am Med Inform Assoc Date: 2016-03-19 Impact factor: 4.497
Authors: Monika M Safford; Susan Andreae; Andrea L Cherrington; Michelle Y Martin; Jewell Halanych; Marquita Lewis; Ashruta Patel; Ethel Johnson; Debra Clark; Christopher Gamboa; Joshua S Richman Journal: Ann Fam Med Date: 2015-08 Impact factor: 5.166
Authors: Sara Belle Donevant; Robin Dawson Estrada; Joan Marie Culley; Brian Habing; Swann Arp Adams Journal: J Am Med Inform Assoc Date: 2018-10-01 Impact factor: 4.497
Authors: Elizabeth Burner; Mark Zhang; Sophie Terp; Kelsey Ford Bench; Joshua Lee; Chun Nok Lam; Jesus R Torres; Michael Menchine; Sanjay Arora Journal: JMIR Mhealth Uhealth Date: 2020-06-04 Impact factor: 4.773