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Improving self-care decisions of medically underserved African Americans with uncontrolled diabetes: effectiveness of patient-driven text messaging versus health coaching
Investigator (PI): Bailey, James
Performing Organization (PO): (Current): University of Tennessee Health Science Center, Center for Health System Improvement / (901) 488-2475
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2016
Final Year: 2021
Record Source/Award ID: PCORI/IHS-1503-28336
Funding: Total Award Amount: $5,229,554
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: The goal of this study is to compare how well motivational messages (text messages from the doctor's office), diabetes wellness coaches, and usual care with diabetes education materials provided at the doctor's office work to help African American adults with uncontrolled diabetes improve diabetes self-care decisions. Self-care is difficult when one has diabetes. But it becomes especially difficult when the diabetes is uncontrolled, the person has other medical conditions, and lives in an area without many primary care doctors. Many studies have shown that encouraging text messages from the doctor's office and health coaches can help people take better care of themselves. But before primary care clinics around the country start sending texts, hiring health coaches, or providing additional educational materials, it is critical for them to know which one is more likely to help. This study will assign African American diabetics to either motivational messages, diabetes wellness coaches, or usual care with diabetes educational materials. We especially want to find out if one works better for people at highest risk, like people who can't read medical information well, people who are very ill, people with depression, people who don't have smartphones, or older adults. We also want to know if one works better for people who live in the city versus people who live in the country. Lastly, we want to find out if messages or coaches help people improve their blood sugar, quality of life, and their feelings about primary care. The study will test motivational messages, diabetes wellness coaches, and usual care with diabetes educational materials side by side in primary care doctors' offices. The messaging and coaching programs will give patients the same information, but in different ways. The motivational messages will come from the doctor's office as text messages to the patient's mobile phone. The messages will be written carefully based on each patient's needs and interests, to give people support with reaching their goals for healthy eating, physical activity, and medication taking. The diabetes wellness coaches will be trained in how to help people get motivated. They will meet with people about once a month to give people support with reaching their goals for healthy eating, physical activity, and medication taking. This study will include 1,000 African American adults, ages 35 to 75, with uncontrolled diabetes and one or more additional chronic condition, living in medically underserved communities in the mid-South. People will have to have a cell phone or smart phone with texting capability to participate. Forty percent of participants will get messages, 40 percent will get coaches for one year, and 20 percent will receive usual care with diabetes educational materials. We will be able to tell whether messages and coaches work by seeing if people improve their diabetes self-care decisions, and if their blood sugar, quality of life, and feelings about primary care get better. Our long-term goal is to get primary care clinics nationally to start using motivational messages or diabetes wellness coaches if they work well.
MeSH Terms:
  • Adult
  • African Americans
  • Aged
  • Blood Glucose /analysis
  • Chronic Disease
  • Comparative Effectiveness Research
  • * Decision Making
  • Diabetes Mellitus /*epidemiology
  • /*therapy
  • Health Promotion /*methods
  • Humans
  • Medically Underserved Area
  • Middle Aged
  • Motivation
  • Motivational Interviewing
  • Patient-Centered Care
  • Primary Health Care /organization & administration
  • Quality of Life
  • Reminder Systems
  • Risk
  • * Self Care
  • Smartphone
  • Text Messaging
  • Urban Population
Country: United States
State: Tennessee
Zip Code: 38163
UI: 20162148
CTgovId: NCT02957513
Project Status: Ongoing
Record History: ('2018: Project extended to 2021.',) ('2017: Project extended to 2020',)