Project Summary
Diabetes is a complicated disease that can cause heart attack, stroke, kidney failure, and eye problems. Patients with diabetes need to monitor their blood sugar, follow a diabetic diet, exercise regularly, take multiple medications, and get regular checkups of their blood pressure, cholesterol, eyes, and feet. To assist with organizing these tasks, a community health worker, attached to a patient’s clinic, can help patients understand the care of their diabetes and keep patients in contact with their doctors. In addition to a community health worker, there are new cell phone systems that have programs to assist with diabetes care. The cell phone system can provide immediate feedback to diabetes patients on how they are doing and send advice to their healthcare team on how to do better. The cell phone system information will be regularly reviewed by the healthcare team community health worker to provide patients with added advice. This study will compare the benefit of providing patients with diabetes with a cell phone system alone versus providing patients with both a community health worker and a cell phone with an electronic system for following their diabetes and, if needed, blood pressure. As participants in this study, 200 diabetes patients with Medicaid insurance will be followed for 12 months in the medical clinics at George Washington University, Howard University, or the Washington Hospital Center. Participants will be assigned to one of three groups. Group 1 will use the diabetes cell phone system alone. Group 2 will be assigned a community health worker, and group 3 will have both the cell phone system and a community health worker. Those patients using the cell phone system will be taught how to use the phone to monitor their blood sugar and other diabetes needs and keep in contact with their community health worker and their medical team. All participants will be asked to fill out questionnaires at the first visit and 6 and 12 months later. Patients using the cell phone will be asked to enter their blood sugar and blood pressure readings on the system. Patients can use their own cell phone or can be provided with a free phone and service. Those using their own phone will be reimbursed for SMS texting services. Those study subjects not using the cell phone will receive $15 every month for their participation. At the end of the study, we will compare the patients who used the cell phone system alone and the community health worker alone to those who had both a community health worker and the cell phone diabetes program to see which approach is most helpful for patients to improve wellness behaviors and clinical outcome goals.
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