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  • Research & Results
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  • Comparing Motivational Text Messaging...

Comparing Motivational Text Messaging, Health Coaching, and Enhanced Usual Care for African Americans with Diabetes—the Management of Diabetes in Everyday Life, or MODEL, Study

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Project Summary  

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

In the United States, 13 percent of African-American adults have diabetes. Eating healthy food, exercising regularly, and tracking blood sugar can help people with diabetes stay healthy. But making changes can be hard.

Studies have shown that working with health coaches or getting encouraging text messages from doctors’ offices can help patients make healthy choices. The research team wants to compare how well these approaches help African Americans with diabetes improve their self-care. Types of self-care include diet, exercise, blood sugar testing, foot care, taking medicine, and stopping smoking. In this study, the research team is focusing on people who live in communities with few resources.

Who can this research help?

Doctors and health system leaders can use results of this research when considering ways to help patients with diabetes improve their health.

What is the research team doing?

The research team is recruiting 646 African-American adults age 18 and older who have diabetes along with other health problems. The team is assigning patients by chance to one of three groups:

  • Text support: Patients get text messages from their doctors’ office for one year. The text messages are based on the patient’s needs and interests. They address topics such as healthy eating, exercise, and setting goals to take medicine.
  • Health coaching: Patients work with a health coach for one year. The health coaches offer support on topics such as healthy eating, exercise, and taking medicine. Meetings take place twice a month for the first two or three months, and then monthly for the remainder of the year.
  • Enhanced usual care: Patients receive educational materials and access to support services, such as peer group support sessions. Doctors and nurses who treat patients receive training on ways to support patients with diabetes.

Over one year, the research team is comparing changes in health behaviors for patients who take part in each group. The team is looking for changes in patients’ diabetes self-care. In addition, the team is studying patients’ blood sugar levels, quality of life, and feelings about primary care.

Patients, doctors, and community group leaders taking part in the Diabetes Wellness and Prevention Coalition of the Mid-South and MODEL learning collaborative are working with the research team to plan and conduct this study.

Research methods at a glance

Design Elements Description
Design Randomized controlled trial
Population African-American adults age 18 and older with uncontrolled diabetes and one or more additional chronic conditions, living in medically underserved communities in the Mid-South
Interventions/
Comparators
  • Motivational text messages
  • Diabetes wellness health coaches
  • Enhanced usual care with diabetes educational materials, peer support, and provider training
Outcomes

Primary: diabetes self-care activities, such as changes in diet, exercise, and taking medicine

Secondary: diabetes self-care activities, such as changes in diet, exercise, and taking medicine

Timeframe 1-year follow-up for primary outcome

Journal Articles

Related Articles

Data in Brief

Using preliminary data and prospective power analyses for mid-stream revision of projected group and subgroup sizes in pragmatic patient-centered outcomes research

Contemporary Clinical Trials

The management of diabetes in everyday life study: Design and methods for a pragmatic randomized controlled trial comparing the effectiveness of text messaging versus health coaching

Translational Behavioral Medicine

The Management of Diabetes in Everyday Life (MODEL) program: development of a tailored text message intervention to improve diabetes self-care activities among underserved African-American adults

Translational Behavioral Medicine

The Management of Diabetes in Everyday Life (MODEL) program: development of a tailored text message intervention to improve diabetes self-care activities among underserved African-American adults

Journal of the American Pharmacists Association

Beyond the Reminder: The Next Steps in Pharmacist-Driven, mHealth Patient Engagement

Tennessee Medicine's e-Journal

Primary Care Patients in Medically Underserved Areas Not Routinely Receiving Diabetes Educational Materials

Health Services Research and Managerial Epidemiology

Unmet Primary Care Needs in Diabetic Patients with Multimorbidity in a Medically Underserved Area

Journal of Telemedicine and Telecare

Use of and interest in mobile health for diabetes self-care in vulnerable populations

Project Details

Principal Investigator
James Bailey, MD, MPH
Project Status
In progress; Recruiting
Project Title
Improving Self-Care Decisions of Medically Underserved African-Americans with Uncontrolled Diabetes: Effectiveness of Patient-Driven Text Messaging versus Health Coaching
Board Approval Date
January 2016
Project End Date
September 2021
Organization
University of Tennessee Health Sciences Center
Year Awarded
2016
State
Tennessee
Project Type
Research Project
Health Conditions  
Cancer
Multiple/Comorbid Chronic Conditions
Cardiovascular Diseases
Stroke
Coronary or Ischemic Heart Disease
Hypertension
Congestive Heart Failure
Kidney Diseases
Chronic Kidney Disease
Mental/Behavioral Health
Depression
Muscular and Skeletal Disorders
Arthritis
Nutritional and Metabolic Disorders
Diabetes
Respiratory Diseases
Asthma
Respiratory Diseases
Chronic Obstructive Pulmonary Disease
Intervention Strategies
Behavioral Interventions
Other Clinical Interventions
Other Health Services Interventions
Technology Interventions
Training and Education Interventions
Populations
Racial/Ethnic Minorities
Low Health Literacy/Numeracy
Low Income
Older Adults
Rural
Individuals with Multiple Chronic/co-morbid Conditions
Funding Announcement
Improving Healthcare Systems
Project Budget
$5,017,208
Study Registration Information
HSRP20162148
NCT02957513
Page Last Updated: 
February 20, 2020

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Meetings & Events

February 2
PCORI 2021 and Beyond: Opportunities for Funding and Involvement in Patient-Centered Research
February 9
Board of Governors Meeting: February 9, 2021
February 11
Advisory Panel on Patient Engagement Winter 2021 Meeting

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