Results Summary

What was the research about?

Diabetes is a long-term health problem that causes blood sugar levels to rise. Keeping blood sugar levels within a healthy range can help prevent damage to the body. Self-care activities like eating healthy, exercising, and taking medicine as recommended can help people manage their diabetes. But making changes can be hard, especially for people with other chronic health problems, like high blood pressure, or for those who live in low-income areas.

In this study, the research team compared three approaches for improving self-care activities among African-American adults with diabetes and other chronic health problems who live in low-income areas:

  • Education guide alone. Patients received a diabetes education guide and went over it with a member of the research team. The guide included information about diabetes, healthy behaviors, and community and online resources.
  • Text messaging plus guide. Patients received the guide and also received texts with health information and reminders for one year. Patients helped decide how often they would get texts and what topics would be covered.
  • Health coaching plus guide. Patients received the guide and also had in-person or phone meetings with a trained health coach at least once a month for one year. Coaches helped patients set health goals, create healthy habits, and find social support.

What were the results?

After one year, in all three approaches, patients reported that they increased the number of days they followed a healthful eating plan and exercised. They didn’t improve how often they took their medicine.

Compared with patients who received the education guide alone:

  • Patients who also received text messages reported more days of following a healthful eating plan.
  • Patients who also received coaching didn’t differ in the number of days they followed a healthful eating plan.

Across the three approaches, patients didn’t differ in the number of days they exercised or took diabetes medicines as recommended.

Who was in the study?

The study included 666 African-American adults with diabetes and one or more chronic health problems. All received care at one of 18 clinics in the Mid-South region. The average age of patients was 54, and 67 percent were women. Also, 90 percent of patients lived in low-income areas.

What did the research team do?

The research team assigned patients by chance to one of the three approaches.

At the start of the study and again one year later, patients completed surveys about their self-care activities.

Patients, doctors, and community groups provided input during the study.

What were the limits of the study?

This study took place in the Mid-South region; results may differ in other regions. Most patients took diabetes medicine as recommended when the study began. As a result, it was hard to see improvements.

Future research could look at delivering the three approaches together to improve self-care or allowing patients to choose the approach they like best.

How can people use the results?

Doctors and clinics can use these results when considering approaches to best support African-American adults with diabetes and other chronic health problems living in low-income areas.

Final Research Report

This project's final research report is expected to be available by September 2023.

Journal Citations

Related Journal Citations

Peer-Review Summary

The Peer-Review Summary for this project will be posted here soon.

Project Information

James E. Bailey, MD, MPH
The University of Tennessee Health Science Center
$5,017,208
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

Key Dates

January 2016
May 2022
2016
2022

Study Registration Information

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Last updated: January 18, 2023