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
  • Motivational text messages
  • Diabetes wellness health coaches
  • Enhanced usual care with diabetes educational materials, peer support, and provider training

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 Citations

Related Journal Citations

Project Information

James Bailey, MD, MPH
University of Tennessee Health Sciences Center
Improving Self-Care Decisions of Medically Underserved African-Americans with Uncontrolled Diabetes: Effectiveness of Patient-Driven Text Messaging versus Health Coaching

Key Dates

January 2016
May 2022

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
Research Priority Area
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 15, 2022