Effects of a tailored text messaging intervention among diverse adults with type 2 diabetes: Evidence from the 15-month REACH RCT

Objective: Text messaging interventions have high potential for scalability and to reduce health disparities; however, more rigorous, long-term trials are needed. We examined the long-term efficacy and mechanisms of a tailored text messaging intervention. Research Design and Methods: Adults with type 2 diabetes participated in a parallel-groups, 15-month randomized trial, assigned to receive REACH (Rapid Education/Encouragement and Communications for Health) for 12 months or control. REACH included interactive texts and tailored texts addressing medication adherence, and non-tailored texts supporting other self-care behaviors. Outcomes included HbA1c, diabetes medication adherence, self-care, and self-efficacy. Results: Participants (N=506) were approximately half racial/ethnic minority and half were underinsured, had annual household incomes <$35,000 USD and ≤ high school education; 11% were homeless. <a>Average baseline HbA1c was 8.6%±1.8%; 70.0±19.7 mmol/mol) with n=219 having HbA1c≥8.5% (69 mmol/mol)</a> and half were prescribed insulin. Retention was over 90%. Median response rate to interactive texts was 91% (interquartile range 75%, 97%). The treatment effect on HbA1c at 6 months (-0.31%; 95% CI [-0.61%, -0.02%]) was greater among those with baseline HbA1c≥8.5% (-0.74%; 95% CI [-1.26%, -0.23%]), and there was not evidence of effect modification by race/ethnicity or socioeconomic disadvantage. REACH improved medication adherence and diet through 12 months, and self-efficacy through 6 months. Treatment effects were not significant for any outcome at 15 months. REACH reduced barriers to adherence, but barrier reduction did not mediate outcome improvements. Conclusions: REACH engaged at-risk patients in diabetes self-management and improved short-term HbA1c. More than texts alone may be needed to sustain effects.

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Effects of a tailored text messaging intervention among diverse adults with type 2 diabetes: Evidence from the 15-month REACH RCT

10.2337/figshare.13052981.v1 ◽

2020 ◽

Author(s):

Lyndsay A. Nelson ◽

Robert A. Greevy ◽

Andrew Spieker ◽

Kenneth A. Wallston ◽

Tom A. Elasy ◽

...

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Self Efficacy ◽

Text Messaging ◽

Self Care ◽

Baseline Hba1c ◽

Median Response ◽

Text Messaging Intervention

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Mixed-Methods Randomized Evaluation of FAMS: A Mobile Phone-Delivered Intervention to Improve Family/Friend Involvement in Adults’ Type 2 Diabetes Self-Care

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa041 ◽

2020 ◽

Author(s):

Lindsay S Mayberry ◽

Cynthia A Berg ◽

Robert A Greevy ◽

Lyndsay A Nelson ◽

Erin M Bergner ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Mobile Phone ◽

Self Efficacy ◽

Text Messaging ◽

Intervention Group ◽

Self Care ◽

Treatment As Usual ◽

Text Messaging Intervention

Abstract Background Family and friends have both helpful and harmful effects on adults’ diabetes self-management. Family-focused Add-on to Motivate Self-care (FAMS) is a mobile phone-delivered intervention designed to improve family/friend involvement, self-efficacy, and self-care via monthly phone coaching, texts tailored to goals, and the option to invite a support person to receive texts. Purpose We sought to evaluate how FAMS was received by a diverse group of adults with Type 2 diabetes and if FAMS improved diabetes-specific family/friend involvement (increased helpful and reduced harmful), diabetes self-efficacy, and self-care (diet and physical activity). We also assessed if improvements in family/friend involvement mediated improvements in self-efficacy and self-care. Methods Participants were prospectively assigned to enhanced treatment as usual (control), an individualized text messaging intervention alone, or the individualized text messaging intervention plus FAMS for 6 months. Participants completed surveys at baseline, 3 and 6 months, and postintervention interviews. Between-group and multiple mediator analyses followed intention-to-treat principles. Results Retention, engagement, and fidelity were high. FAMS was well received and helped participants realize the value of involving family/friends in their care. Relative to control, FAMS participants had improved family/friend involvement, self-efficacy, and diet (but not physical activity) at 3 and 6 months (all ps < .05). Improvements in family/friend involvement mediated effects on self-efficacy and diet for FAMS participants but not for the individualized intervention group. Conclusions The promise of effectively engaging patients’ family and friends lies in sustained long-term behavior change. This work represents a first step toward this goal by demonstrating how content targeting helpful and harmful family/friend involvement can drive short-term effects. Trial Registration Number NCT02481596.

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Impact of Distress Reduction on Behavioral Correlates and A1C in African American Women with Uncontrolled Type 2 Diabetes: Results from EMPOWER

Ethnicity & Disease ◽

10.18865/ed.27.2.155 ◽

2017 ◽

Vol 27 (2) ◽

pp. 155 ◽

Cited By ~ 2

Author(s):

Doyle M. Cummings ◽

Lesley D. Lutes ◽

Kerry Littlewood ◽

Chelsey Solar ◽

Bertha Hambidge ◽

...

Keyword(s):

Type 2 Diabetes ◽

African American ◽

Medication Adherence ◽

Glycemic Control ◽

African American Women ◽

Self Efficacy ◽

Self Care ◽

Behavioral Correlates ◽

American Women

Objective: Symptoms of emotional distress related to diabetes have been associated with inadequate self-care behaviors, medication non-adherence, and poor glycemic control that may predispose patients to premature death. African American women, in whom diabetes is more common and social support is often insufficient, may be at particularly high risk. The objective of this study was to examine the impact of lowering diabetes-related emotional distress on glycemic control and associated behavioral correlates in rural African American women with uncontrolled type 2 diabetes (T2D).Design: Post-hoc analysis of prospective, randomized, controlled trial.Setting: Rural communities in the southeastern United States.Patients: 129 rural middle-aged African American women with uncontrolled type 2 diabetes (T2D)(A1C ≥ 7.0).Primary Independent Variable: Diabetes-related distress.Main Outcome Measures: Changes from baseline to 12-month follow-up in diabetes-related distress, and associated changes in medication adherence, self-care activities, self-efficacy, and glycemic control (A1C).Results: Patients with a reduction in diabetes-related distress (n=79) had significantly greater improvement in A1C, medication adherence, self-care activities, and self-efficacy compared with those in whom diabetes distress worsened or was unchanged (n=50). Changes in distress were also significantly and inversely correlated with improvements in medication adherence, self-care activities, and self-efficacy.Conclusions: Among rural African American women, reductions in diabetes-related distress may be associated with lower A1C and improvements in self-efficacy, self-care behaviors, and medication adherence.Ethn Dis. 2017;27(2):155-160; doi:10.18865/ed.27.2.155.

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Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

Oman Medical Journal ◽

10.5001/omj.2016.10 ◽

2016 ◽

Vol 31 (1) ◽

pp. 52-59 ◽

Cited By ~ 34

Author(s):

Mahnoush Reisi ◽

Firoozeh Mostafavi ◽

Homamodin Javadzade ◽

Behzad Mahaki ◽

Elahe Tavassoli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Self Efficacy ◽

Self Care ◽

Outcome Expectations

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Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study

10.21203/rs.2.21066/v2 ◽

2020 ◽

Author(s):

Ming-Jye Wang ◽

Hung-Ming Lin ◽

Li-Chen Hung ◽

Yi-Ting Lo

Keyword(s):

Type 2 Diabetes ◽

Decision Making ◽

Health Literacy ◽

Self Efficacy ◽

Patient Empowerment ◽

Self Care ◽

Cross Sectional Study ◽

Medical Decision ◽

Cross Sectional

Abstract Background: The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making.Methods: A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via self-administered questionnaires. Partial least squares structural equation modeling was used for analysis.Results: Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making. Conclusions: Health literacy is a critical factor in improving self-care behaviors in patients with type 2 diabetes, and the effect of health literacy on self-efficacy was more significant in the shared decision-making than in the physician decision-making. Therefore, developing an effective health strategy to strengthen health literacy awareness and designing friendly, diverse health literacy materials, and application tools is the most important factor to facilitate self-care behaviors in this population.

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The Role Of Family Support And Self-Efficacy On Self-Care Behavior In The Elderly With Type 2 Diabetes

Journal of Health Sciences ◽

10.33086/jhs.v14i02.1801 ◽

2021 ◽

Vol 14 (02) ◽

pp. 82-89

Author(s):

Ratna Yunita Sari ◽

Umdatus Soleha ◽

Erika Chandra Dewi

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Family Support ◽

Self Efficacy ◽

Self Care ◽

The Elderly ◽

Rank Test ◽

Care Behavior

Introduction: Diabetes self-care is an effort to control type 2 diabetes mellitus. Family support and self-efficacy are needed for elderly people with type 2 diabetes mellitus to increase independence in managing their disease. This study aims to determine the relationship between family support and self-efficacy with self-care behavior in the elderly with type 2 diabetes mellitus at the Elderly Posyandu in Wadungasri Village. Methods: This study is a quantitative study with a correlational analytic research design using a cross-sectional approach. The population in this study was 132 elderly with type 2 diabetes mellitus using a probability sampling method with a technique used simple random sampling and obtained a sample of 100 elderly DM type 2. Results: The results showed that most of the elderly have family support and good self-efficacy. with less self-care behavior. The results of the analysis using the Spearman rank test showed that family support was associated with self-care for people with diabetes mellitus type 2 (p-value = 0.006, ɑ = 0.05). The results of the Spearman rank test analysis showed that self-efficacy was related to self-care for people with diabetes mellitus type 2 (p-value = 0.001, ɑ = 0.05). Conclusion: Family support and self-efficacy gave to elderly people with type 2 diabetes mellitus can influence health behavior patterns that will make self-care behavior well.

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Factors Related to Self-care in Patients with Type 2 Diabetes

The Open Nursing Journal ◽

10.2174/1874434602014010064 ◽

2020 ◽

Vol 14 (1) ◽

pp. 64-73

Author(s):

Seung-Yeon Kong ◽

Mi-Kyoung Cho

Keyword(s):

Type 2 Diabetes ◽

Self Efficacy ◽

Smoking Status ◽

Explanatory Power ◽

Fasting Blood Glucose ◽

Self Care ◽

Self Report ◽

University Hospital ◽

Diabetes Patients

Purpose: The prevalence of diabetes and the personal and national burden from diabetes, a serious health issue around the globe, continues to increase. The purpose of this study was to identify factors influencing self-care among patients with type 2 diabetes. Methods: We conducted a cross-sectional descriptive survey of 118 outpatients with type 2 diabetes in national university hospital C in Korea. Data were collected from self-report questionnaires covering information on demographics, self-care, and self-efficacy. Additional data were collected from medical records including information on HbA1c, fasting blood glucose levels, and cholesterol levels. Collected data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression using SPSS/WIN version 22.0 software. Results: Factors affecting self-care were the following four: self-efficacy, HbA1c, occupation status, and smoking status. Higher engagement in self-care was associated with higher self-efficacy (β = .53, p < .001), lower HbA1c (β = -0.33, p < .001), unemployment (β = -0.20, p < .001), and non-smoking status (β = -0.15, p = .011). The regression model of self-care among the type 2 diabetes patients was statistically significant (F = 67.15, p < .001), and the explanatory power of the adjusted R2 was 69%. Conclusion: Type 2 diabetes patients with high self-efficacy and self-care scores showed good glycemic control. Therefore, this finding suggests that nursing interventions should be developed to enhance self-efficacy, which is the greatest influencing factor for self-care.

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