A primary care text messaging initiative to improve type 2 diabetes self-management in Hispanic adults

The purpose of this doctoral project is to improve the quality of care at a primary care clinic through the implementation of a text message intervention via a mobile phone device to improve glycosylated hemoglobin A1C levels, decrease body mass index (BMI), and increase diabetes self-management knowledge in Hispanic adults, aged 20 years or older, and diagnosed with type 2 diabetes (T2DM). A quality improvement (QI) design which included adult men and women with a hemoglobin A1C > 7% in a primary care office was used. T2DM is defined as glycosylated hemoglobin A1C that is greater than, or equal to, 6.5%. The optimal aim for effective control of T2DM is a maintained hemoglobin A1C level less than 7%. Intervention consisted of a power point presentation for the providers on updated management of care for patients diagnosed with T2DM. The results of a chart audit depicted improvement in knowledge and quality of diabetes practices among providers in the primary care clinic over time. The 3- month text messaging program consisted of 25 participants who were given educational material on T2DM. Participants received two text messages daily for 3-months with supportive, educational, and reminder texts regarding T2DM. Pre- and post-intervention measurements for mean hemoglobin A1C levels, DKT2 scores, and BMI were collected. Reductions in hemoglobin A1C measurements and BMI, and an increase in diabetic knowledge were observed. The mean pre- and post-intervention p-values demonstrated that the implementation of a text messaging program was statistically significant. Further investigation is needed for enhancing text message programs, such as the content and method of texting. Diabetic education via text messages has the capability to encourage modifications of one’s daily routine thus reducing modifiable elements that raise one’s chances of diabetes.