Mobile Health Technology as an Intervention for Diabetes Self-Management
- Conditions
- Type II Diabetes Mellitus
- Interventions
- Other: Participation in Care4Life
- Registration Number
- NCT01546844
- Lead Sponsor
- HealthInsight
- Brief Summary
This purpose of this is study is to evaluate the effectiveness of an interactive mobile health information service, Care4Life, in supporting patient self-management of Type II Diabetes Mellitus.
- Detailed Description
This study evaluates the effectiveness of an interactive mobile health information service, Care4Life, in supporting patient self-management through its ability to facilitate patient education, behavior change, and improved adherence with standard care practices. The study population comprises adults who have been diagnosed with Type 2 diabetes mellitus (DM) and a hemoglobin A1c (HbA1c) test above 8% in the past year. All members of the study population are treated at primary care clinics under the auspices of the Utah Beacon Community Program, which aims to improve health through use of health information technology. We will compare outcomes in two groups within this population: patients with DM who enroll in Care4Life (in addition to receiving standard care) to patients with DM who receive standard care from their physician. We will compare these groups both within the clinic and at an aggregated, overall level.
This study relies on the use of information and communications technology (ICT) in supporting patient-empowerment strategies. Features of successful diabetes care programs for improving adherence to standards of care, such as the use of diabetes self-management education, checklists that mirror guidelines, and automated reminders are well suited to delivery using an interactive mobile health platform.
Research Questions
This study will evaluate the efficacy of the Care4Life mHealth program by:
1. Evaluating if a short message service via cell phone texting (SMS) protocol will lead to improvements in clinical, utilization and satisfaction outcomes for patients with DM compared to patient who receive standard care.
2. Evaluating if an SMS protocol can be readily adopted by an adult population in both urban and rural areas with a time-consuming chronic illness.
Targeted outcomes include:
1. Improved measures of diabetes control, demonstrated as HbA1c percentage levels ≤ 8%; improved blood pressure (BP) control, demonstrated as BP ≤ 140/90 millimeters mercury (mm Hg); and lower body mass index (BMI) among users of the SMS-based tool.
2. Improved knowledge of self-care and disease management practices among adult patients with diabetes treated in Beacon clinics in the Salt Lake Metropolitan Statistical Area (Salt Lake, Tooele, and Summit counties).
3. Dissemination of results and proof of concept with the broader healthcare community in Utah.
The mobile centric diabetes support service at the center of our study is Voxiva's Care4Life platform, which is an interactive mobile application designed to educate participants, encourage behavior change and promote adherence to their prescribed DM treatment protocol. It includes a series of SMS-based tools that have been developed in collaboration with the Instituto Carso de la Salud, located in Mexico. The service sends content relevant to the target participants and their standard treatment protocol. Care4Life delivers an individually tailored diabetes education and management plan based on data that are collected from patients at enrollment and added to the participant's personal health profile.
The SMS protocol draws on the experience of a number of interventions that have been independently studied and shown to improve health outcomes. Care4Life functionality consists of the following components: (1) a diabetes diary that can be used to develop a history of glucose levels and trigger alerts and feedback based on the participant's results; (2) health education with content tailored to the participant's health profile; (3) medication adherence reminders and monitoring; (4) medical appointment reminders; (5) a database that allows a participant to record and monitor her/his weight, BMI, blood pressure and laboratory results; and (6) a health portal that allows a participant to review his/her data, obtain advice and guidance based on the information entered, and manage his/her preferences.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 500
- Laboratory test for HbA1c ≥ 8% within the past year
- Clinical diagnosis of DM
- Age > 18 years old
- Patient in a Beacon clinic
- Cell phone ownership or willingness to acquire a cell phone capable of receiving and sending SMS messages
- Women who are not pregnant
- Failure to meet inclusion criteria
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Care4Life Participation in Care4Life Text message and online interactive component to help patients with self-management.
- Primary Outcome Measures
Name Time Method Change in Hemoglobin A1c - In control, over time. 3, 6, 9, and 12 months Hemoglobin A1c - In control as assessed by laboratory results of blood draw taken from patient's clinic. In control means a result of \<9%.
- Secondary Outcome Measures
Name Time Method Change in Blood Pressure Control over time 3, 6, 9, 12 months Improved blood pressure (BP) control as demonstrated as BP ≤ 140/90 millimeters mercury (mm Hg)
Change in BMI over time 3, 6, 9, 12 months Lower body mass index (BMI) among users of the SMS-based tool.
Disease Management 12 months Improved knowledge of self-care and disease management practices among adult patients with diabetes treated in Beacon clinics in the Salt Lake Metropolitan Statistical Area (Salt Lake, Tooele, and Summit counties).
Trial Locations
- Locations (30)
Olympus Clinic
🇺🇸Holladay, Utah, United States
Wasatch Internal Medicine
🇺🇸Salt Lake City, Utah, United States
Pioneer Comprehensive Medical
🇺🇸Draper, Utah, United States
HealthInsight
🇺🇸Salt Lake City, Utah, United States
Jordan Meadows Medical Center
🇺🇸West Jordan, Utah, United States
Coalville Health Center
🇺🇸Coalville, Utah, United States
Advanced Practice Medical Clinic
🇺🇸Tooele, Utah, United States
Holladay Family Practice
🇺🇸Holladay, Utah, United States
Exodus Healthcare - Main Office - Magna
🇺🇸Magna, Utah, United States
Granger Medical-Riverton
🇺🇸Riverton, Utah, United States
Barbara E. Rizzardi, M.D.
🇺🇸Sandy, Utah, United States
Valley Family Medicine
🇺🇸Tooele, Utah, United States
Community Health Centers Inc. - 72nd Street Clinic
🇺🇸Midvale, Utah, United States
Utah Physicians Care Centers - St Mark's Internal Medicine
🇺🇸Salt Lake City, Utah, United States
Copperview Medical Center, Llc
🇺🇸South Jordan, Utah, United States
Granger Medical - Jordan Medical Arts
🇺🇸West Jordan, Utah, United States
Granger Medical Clinic Inc. - Main Office
🇺🇸West Valley City, Utah, United States
Community Health Centers Inc. - Oquirrh View
🇺🇸Taylorsville, Utah, United States
West Valley Family And Preventive Medicine
🇺🇸West Valley City, Utah, United States
Riverton Family Health Center
🇺🇸Riverton, Utah, United States
Alpine Internal Medicine
🇺🇸Salt Lake City, Utah, United States
Park City Healthcare, Inc.
🇺🇸Park City, Utah, United States
Central City Community Health Center Health First Family Medicine
🇺🇸Salt Lake City, Utah, United States
Wasatch Homeless Health Care - 4th Street Clinic
🇺🇸Salt Lake City, Utah, United States
Health Clinic Of Utah - SLC
🇺🇸Salt Lake City, Utah, United States
Evolutionary Healthcare, Llc
🇺🇸Salt Lake City, Utah, United States
Utah Healthcare Institute - St. Mark's Family Medicine
🇺🇸Salt Lake City, Utah, United States
Stephen D. Ratcliffe Community Health Center
🇺🇸Salt Lake City, Utah, United States
Jordan Ridge Family Medicine
🇺🇸Salt Lake City, Utah, United States
Kathryn Allen, MD
🇺🇸West Valley City, Utah, United States