Phone Messaging to Prompt Physical Activity and Social Support Among Low-Income Latino Patients With Type 2 Diabetes: A Randomized Pilot Study

Magaly Ramirez, Shinyi Wu, Magaly Ramirez, Shinyi Wu

Abstract

Background: Given disparities in diabetes prevalence, receipt of diabetes education, diabetes knowledge, and self-management behaviors among Latinos, there is a need to provide education and ongoing support to this population. Phone-based interventions have the potential to reach and engage both patients and their family members and friends.

Objective: The aim of this study was to investigate the feasibility, perceived usefulness, and potential effectiveness of a short text or voice message (STVM) intervention to activate (1) physical activity (PA) behavior change among urban, low-income Latino adults with type 2 diabetes and (2) supportive behaviors by their family members and friends.

Methods: A 12-week pilot study randomized 42 participants recruited in person from a safety-net ambulatory care clinic in Los Angeles into one of the 3 study arms: control, phone messaging (PM), and phone messaging plus social support from family members and friends (PM+FF). All participants were prompted to set PA goals and to self-monitor PA behavior using pedometers and walking logs. PM and PM+FF participants received STVMs with reminders to review goals and self-monitor, PA behavior change education, and feedback on performance. Participants in the PM+FF arm also had their family members and friends receiving STVMs with suggestions for how they could support the participant's PA behavior change efforts. Participants completed semistructured assessments in person at baseline, 6 weeks, and 12 weeks. Outcomes were PA (steps/day) and perceived social support from family members and friends.

Results: Among PM and PM+FF participants, those who opted to receive text messages (short message service, SMS) responded to 62.7% (128/204) of SMS text messages requiring a response while those who opted to receive voice messages responded 30% (12/40) of the time. Participants perceived guidance in self-regulation as useful, particularly self-monitoring, goal setting, self-instruction, feedback, and social support. All participants increased PA at 6 weeks, but only the PM and PM+FF arms increased PA at 12 weeks. All study arms experienced an increase in perceived social support from family members and friends at 6 weeks, but only those in the PM+FF arm had an increase in the perception of social support at 12 weeks.

Conclusion: Designing an STVM intervention based on self-regulation techniques is feasible and perceived as useful by participants. The STVM intervention has the potential to improve PA in terms of daily steps and perceived social support from family members and friends.

Trial registration: Clinicaltrials.gov NCT02850770; https://ichgcp.net/clinical-trials-registry/NCT02850770 (Archived by WebCite at http://www.webcitation.org/query?id=1495567756845570).

Keywords: Hispanic Americans; exercise; pilot project; reminder system; self-care; short message service; social support; type 2 diabetes mellitus.

Conflict of interest statement

Conflicts of Interest: None declared.

©Magaly Ramirez, Shinyi Wu. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 06.06.2017.

Figures

Figure 1
Figure 1
Participant flow diagram.
Figure 2
Figure 2
Changes over time in physical activity and perceived social support from family members and friends. Perceived social support is based on the Social Support and Exercise Survey, with higher numbers indicating higher perceived support.

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