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A Mobile Health Intervention to Reduce Diabetes Disparities in Chinese Americans

A Mobile Health Intervention to Reduce Diabetes Disparities in Chinese Americans

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03557697
Enrollment
60
Registered
2018-06-15
Start date
2021-03-01
Completion date
2023-04-21
Last updated
2025-02-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Type2 Diabetes

Keywords

Chinese Americans, SMS intervention

Brief summary

Chinese Americans are one of the fastest growing immigrant groups in the US, who suffer disproportionately high type 2 diabetes (T2D) burden and have poorly controlled T2D. Despite the well-documented T2D disparities in this minority group, limited work has been conducted to improve health outcomes in Chinese Americans. The goal of this Pathway to Independence Award (K99/R00) is to expedite the candidate's transition to an independent investigator who possesses focused expertise in development and evaluation of culturally and linguistically tailored and sustainable interventions to reduce T2D disparities in Chinese Americans. In the K99 phase of this award, the candidate will obtain critical training needed to accomplish this goal and will develop a short message service (SMS) intervention to improve T2D management in Chinese Americans. More specifically, the aims are to 1) characterize barriers and facilitators of glycemic control in Chinese Americans with T2D (Aim 1a); 2) develop culturally and linguistically tailored SMS intervention content (Aim 1b); and 3) assess the feasibility and acceptability of the SMS intervention in a pre-, post-test study (Aim 1c). In the R00 phase, the candidate will refine the SMS intervention based on the K99 pilot data and evaluate the proof-of-concept regarding its efficacy in a pilot randomized controlled trial among 66 Chinese Americans with T2D (Aim 2). Participants will be randomized to one of 2 arms (n=30 each): 1) wait-list control and 2) SMS intervention. Both groups will continue to receive standard of care treatment for their T2D. The SMS group will receive brief lifestyle counseling videos via SMS links. At the end of the study, the wait-list control group will be provided the opportunity to receive the SMS-based counseling videos. Measurements will be obtained at baseline, 3, and 6 months. The primary outcome is HbA1c and secondary outcomes include self-efficacy, diabetes self-management behaviors, dietary intake and physical activity behaviors. Linear mixed modeling will be used to examine the group and group by time interaction effects between the SMS intervention and wait-list control group. Findings from this R00 study will inform a larger full-scale R01 efficacy trial of the SMS intervention, and ultimately, establish the candidate's program of research focused on developing and testing sustainable interventions to reduce disparities in chronic disease outcomes in Chinese Americans. This project can serve as a program model for other chronic disease interventions in Chinese Americans that require lifestyle modification (e.g., prediabetes, hypertension), or for disparities research in other high-risk immigrant populations (e.g., South Asians, Hispanic Americans).

Interventions

BEHAVIORALStandard of Care

At the end of the study the control group will be provided with the opportunity to receive counseling videos delivered via SMS

Participants in the intervention group will receive SMS based video counseling which include both educational and SCT=-based behavioral content. In addition, participants will receive biweekly phone calls from study community health workers to review the video content and clarify questions, set goals, and problem-solve barriers to achieving the goals.

Sponsors

National Institute on Minority Health and Health Disparities (NIMHD)
CollaboratorNIH
NYU Langone Health
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* self-identify as Chinese Immigrant or Chinese American * be able to speak and understand Mandarin * self-report a diagnosis of T2D * baseline HbA1c ≥ 7% * be currently using WeChat or text messages• be willing to receive WeChat or text messages regarding T2D management * express strong interest and confidence in finishing watching 2 diabetes videos each week for a total of 12 weeks * express motivation to make lifestyle changes to control their diabetes * be willing to wear ActiGraph for 8 days

Exclusion criteria

* unable or unwilling to provide informed consent * unable to participate meaningfully in the intervention (e.g., uncorrected sight and hearing impairment) * unwilling to accept randomization assignment * pregnant, plans to becomes pregnant in the next 6 months, or who become pregnant during the study * breastfeeding * live in a facility or other health care setting where they have to control over diabetes self-management

Design outcomes

Primary

MeasureTime frameDescription
Change in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) LevelsBaseline, Month 3HbA1c testing results abstracted from medical record.

Secondary

MeasureTime frameDescription
Change in Stanford Diabetes Self-Efficacy Scale ScoreBaseline, Month 38-item questionnaire asking participants to rate their confidence level in performing specific Type 2 Diabetes self-management behaviors on 10-point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). The total score is the sum of responses and ranges from 8-80; higher scores indicate higher levels of confidence in performing self-management behaviors.
Change in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet ScoreBaseline, Month 3The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The General Diet subscale comprises 2 items rated on a scale from 0-7. The total General Diet score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.
Change in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet ScoreBaseline, Month 3The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Specific Diet subscale comprises 2 items rated on a scale from 0-7. The total Specific Diet score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.
Change in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise ScoreBaseline, Month 3The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Exercise subscale comprises 2 items rated on a scale from 0-7. The total Exercise score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.
Change in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care ScoreBaseline, Month 3The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Foot Care subscale comprises 2 items rated on a scale from 0-7. The total Foot Care score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.
Change in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence ScoreBaseline, Month 3The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Medication Adherence subscale comprises 3 items rated on a scale from 0-7. The total Medication Adherence score is the mean of the item responses and ranges from 0-21, with higher scores indicating better compliance.
Change in Starting The Conversation Scale: FruitsBaseline, Month 3The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Fruit subscale comprises 1 item in which respondents indicate how many cups of fruit, on average, they ate each day in the past 30 days. The total score is estimation of average cups of fruit consumed per day.
Change in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing ScoreBaseline, Month 3The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Blood-Glucose Testing subscale comprises 2 items rated on a scale from 0-7. The total Blood-Glucose Testing score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.
Change in Starting The Conversation Scale: Refined GrainsBaseline, Month 3The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Refined Grains subscale comprises 1 item in which respondents indicate how many cups of refined grains, on average, they ate each day in the past 30 days. The total score is estimation of average cups of refined grains consumed per day.
Change in Starting The Conversation Scale: Whole WheatBaseline, Month 3The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Whole Wheat subscale comprises 1 item in which respondents indicate how many cups of whole wheat, on average, they ate each day in the past 30 days. The total score is estimation of average cups of whole wheat consumed per day.
Change in Starting The Conversation Scale: Sugary DrinksBaseline, Month 3The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Sugary Drinks subscale comprises 1 item in which respondents indicate how many cans of sugary drinks, on average, they consumed each day in the past 30 days. The total score is estimation of average cans of sugary drinks consumed per day.
Change in Starting The Conversation Scale: Starchy FoodsBaseline, Month 3The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Starchy Foods subscale comprises 1 item in which respondents indicate how many cups of starchy foods, on average, they ate each day in the past 30 days. The total score is estimation of average cups of starchy foods consumed per day.
Change in International Physical Activity Questionnaire (IPAQ) ScoreBaseline, Month 37-item self-assessment providing an estimate of the number of minutes per week participants engage in three categories of physical activity: vigorous activity, moderate activity, and walking activity. Results are expressed in metabolic equivalent (MET) minutes per week. MET minutes represent the amount of energy expended carrying out physical activity. Higher scores indicate higher weekly levels of physical activity.
Change in Belief in Self-Management ScoreBaseline, Month 3Participants rated the importance of five self-care behaviors related to diabetes self-care-following a diabetic diet, exercising, self-monitoring blood glucose, taking medication, and checking their feet. Each behavior was rated on a 5-point Likert scale, where 1 indicated not important and 5 indicated very important. The total score is calculated as the mean of the item responses and ranges from 1-5, with higher scores indicating greater belief in the importance of diabetes self-management.
Change in Diabetes Distress Scale ScoreBaseline, Month 3This 17-item scale required participants to rate the extent to which each item was problematic for them in the past month, using a 6-point Likert scale ranging from 1 (no problem) to 6 (serious problem). The total score is the mean of the item scores and ranges from 1-6, with higher scores indicating a greater level of distress.
Change in Starting The Conversation Scale: VegetablesBaseline, Month 3The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Vegetables subscale comprises 1 item in which respondents indicate how many cups of vegetables, on average, they ate each day in the past 30 days. The total score is estimation of average cups of vegetables consumed per day.

Countries

United States

Participant flow

Participants by arm

ArmCount
Wait-list Control
3 measurement visits, baseline, 3, and 6 months Standard of Care: At the end of the study the control group will be provided with the opportunity to receive counseling videos delivered via SMS
30
SMS Intervention
3 measurement visits, baseline, 3, and 6 months SMS Intervention: Participants in the intervention group will receive SMS based video counseling which include both educational and SCT=-based behavioral content. In addition, participants will receive biweekly phone calls from study community health workers to review the video content and clarify questions, set goals, and problem-solve barriers to achieving the goals.
30
Total60

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyWithdrawal by Subject24

Baseline characteristics

CharacteristicSMS InterventionTotalWait-list Control
Age, Continuous55.6 years
STANDARD_DEVIATION 11.5
54.3 years
STANDARD_DEVIATION 11.5
52.9 years
STANDARD_DEVIATION 11.4
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
30 Participants60 Participants30 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
30 Participants60 Participants30 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants
Region of Enrollment
United States
30 participants60 participants30 participants
Sex: Female, Male
Female
12 Participants23 Participants11 Participants
Sex: Female, Male
Male
18 Participants37 Participants19 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 300 / 30
other
Total, other adverse events
0 / 300 / 30
serious
Total, serious adverse events
0 / 300 / 30

Outcome results

Primary

Change in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) Levels

HbA1c testing results abstracted from medical record.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) Levels-0.82 Percentage
SMS InterventionChange in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) Levels-1.08 Percentage
Primary

Change in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) Levels

HbA1c testing results abstracted from medical record.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) Levels-0.68 Percentage
SMS InterventionChange in Average Plasma Glucose Concentration Measured by Hemoglobin A1c (HbA1c) Levels-0.95 Percentage
Secondary

Change in Belief in Self-Management Score

Participants rated the importance of five self-care behaviors related to diabetes self-care-following a diabetic diet, exercising, self-monitoring blood glucose, taking medication, and checking their feet. Each behavior was rated on a 5-point Likert scale, where 1 indicated not important and 5 indicated very important. The total score is calculated as the mean of the item responses and ranges from 1-5, with higher scores indicating greater belief in the importance of diabetes self-management.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Belief in Self-Management Score0.21 score on a scale
SMS InterventionChange in Belief in Self-Management Score0.05 score on a scale
Secondary

Change in Belief in Self-Management Score

Participants rated the importance of five self-care behaviors related to diabetes self-care-following a diabetic diet, exercising, self-monitoring blood glucose, taking medication, and checking their feet. Each behavior was rated on a 5-point Likert scale, where 1 indicated not important and 5 indicated very important. The total score is calculated as the mean of the item responses and ranges from 1-5, with higher scores indicating greater belief in the importance of diabetes self-management.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Belief in Self-Management Score0.21 score on a scale
SMS InterventionChange in Belief in Self-Management Score0.14 score on a scale
Secondary

Change in Diabetes Distress Scale Score

This 17-item scale required participants to rate the extent to which each item was problematic for them in the past month, using a 6-point Likert scale ranging from 1 (no problem) to 6 (serious problem). The total score is the mean of the item scores and ranges from 1-6, with higher scores indicating a greater level of distress.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Diabetes Distress Scale Score0.06 score on a scale
SMS InterventionChange in Diabetes Distress Scale Score-0.37 score on a scale
Secondary

Change in Diabetes Distress Scale Score

This 17-item scale required participants to rate the extent to which each item was problematic for them in the past month, using a 6-point Likert scale ranging from 1 (no problem) to 6 (serious problem). The total score is the mean of the item scores and ranges from 1-6, with higher scores indicating a greater level of distress.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Diabetes Distress Scale Score0.01 score on a scale
SMS InterventionChange in Diabetes Distress Scale Score-0.24 score on a scale
Secondary

Change in International Physical Activity Questionnaire (IPAQ) Score

7-item self-assessment providing an estimate of the number of minutes per week participants engage in three categories of physical activity: vigorous activity, moderate activity, and walking activity. Results are expressed in metabolic equivalent (MET) minutes per week. MET minutes represent the amount of energy expended carrying out physical activity. Higher scores indicate higher weekly levels of physical activity.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in International Physical Activity Questionnaire (IPAQ) Score25.58 metabolic equivalent (MET) minutes/week
SMS InterventionChange in International Physical Activity Questionnaire (IPAQ) Score-196.14 metabolic equivalent (MET) minutes/week
Secondary

Change in International Physical Activity Questionnaire (IPAQ) Score

7-item self-assessment providing an estimate of the number of minutes per week participants engage in three categories of physical activity: vigorous activity, moderate activity, and walking activity. Results are expressed in metabolic equivalent (MET) minutes per week. MET minutes represent the amount of energy expended carrying out physical activity. Higher scores indicate higher weekly levels of physical activity.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in International Physical Activity Questionnaire (IPAQ) Score1032.79 metabolic equivalent (MET) minutes/week
SMS InterventionChange in International Physical Activity Questionnaire (IPAQ) Score199.57 metabolic equivalent (MET) minutes/week
Secondary

Change in Stanford Diabetes Self-Efficacy Scale Score

8-item questionnaire asking participants to rate their confidence level in performing specific Type 2 Diabetes self-management behaviors on 10-point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). The total score is the sum of responses and ranges from 8-80; higher scores indicate higher levels of confidence in performing self-management behaviors.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Stanford Diabetes Self-Efficacy Scale Score0.21 score on a scale
SMS InterventionChange in Stanford Diabetes Self-Efficacy Scale Score6.08 score on a scale
Secondary

Change in Stanford Diabetes Self-Efficacy Scale Score

8-item questionnaire asking participants to rate their confidence level in performing specific Type 2 Diabetes self-management behaviors on 10-point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). The total score is the sum of responses and ranges from 8-80; higher scores indicate higher levels of confidence in performing self-management behaviors.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Stanford Diabetes Self-Efficacy Scale Score-2.72 score on a scale
SMS InterventionChange in Stanford Diabetes Self-Efficacy Scale Score5.76 score on a scale
Secondary

Change in Starting The Conversation Scale: Fruits

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Fruit subscale comprises 1 item in which respondents indicate how many cups of fruit, on average, they ate each day in the past 30 days. The total score is estimation of average cups of fruit consumed per day.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Fruits-0.44 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Fruits0.15 Cups/day
Secondary

Change in Starting The Conversation Scale: Fruits

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Fruit subscale comprises 1 item in which respondents indicate how many cups of fruits, on average, they ate each day in the past 30 days. The total score is estimation of average cups of fruit consumed per day.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Fruits-0.32 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Fruits0.17 Cups/day
Secondary

Change in Starting The Conversation Scale: Refined Grains

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Refined Grains subscale comprises 1 item in which respondents indicate how many cups of refined grains, on average, they ate each day in the past 30 days. The total score is estimation of average cups of refined grains consumed per day.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Refined Grains-0.20 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Refined Grains-0.34 Cups/day
Secondary

Change in Starting The Conversation Scale: Refined Grains

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Refined Grains subscale comprises 1 item in which respondents indicate how many cups of refined grains, on average, they ate each day in the past 30 days. The total score is estimation of average cups of refined grains consumed per day.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Refined Grains-0.20 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Refined Grains-0.59 Cups/day
Secondary

Change in Starting The Conversation Scale: Starchy Foods

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Starchy Foods subscale comprises 1 item in which respondents indicate how many cups of starchy foods, on average, they ate each day in the past 30 days. The total score is estimation of average cups of starchy foods consumed per day.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Starchy Foods-0.07 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Starchy Foods-0.24 Cups/day
Secondary

Change in Starting The Conversation Scale: Starchy Foods

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Starchy Foods subscale comprises 1 item in which respondents indicate how many cups of starchy foods, on average, they ate each day in the past 30 days. The total score is estimation of average cups of starchy foods consumed per day.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Starchy Foods-0.1 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Starchy Foods-0.33 Cups/day
Secondary

Change in Starting The Conversation Scale: Sugary Drinks

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Sugary Drinks subscale comprises 1 item in which respondents indicate how many cans of sugary drinks, on average, they consumed each day in the past 30 days. The total score is estimation of average cans of sugary drinks consumed per day.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Sugary Drinks-0.01 Cans/day
SMS InterventionChange in Starting The Conversation Scale: Sugary Drinks-0.1 Cans/day
Secondary

Change in Starting The Conversation Scale: Sugary Drinks

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Sugary Drinks subscale comprises 1 item in which respondents indicate how many cans of sugary drinks, on average, they consumed each day in the past 30 days. The total score is estimation of average cans of sugary drinks consumed per day.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Sugary Drinks-0.10 Cans/day
SMS InterventionChange in Starting The Conversation Scale: Sugary Drinks-0.16 Cans/day
Secondary

Change in Starting The Conversation Scale: Vegetables

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Vegetables subscale comprises 1 item in which respondents indicate how many cups of vegetables, on average, they ate each day in the past 30 days. The total score is estimation of average cups of vegetables consumed per day.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Vegetables-0.06 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Vegetables0.22 Cups/day
Secondary

Change in Starting The Conversation Scale: Vegetables

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Vegetables subscale comprises 1 item in which respondents indicate how many cups of vegetables, on average, they ate each day in the past 30 days. The total score is estimation of average cups of vegetables consumed per day.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Vegetables0.00 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Vegetables0.52 Cups/day
Secondary

Change in Starting The Conversation Scale: Whole Wheat

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Whole Wheat subscale comprises 1 item in which respondents indicate how many cups of whole wheat, on average, they ate each day in the past 30 days. The total score is estimation of average cups of whole wheat consumed per day.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Whole Wheat-0.18 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Whole Wheat-0.12 Cups/day
Secondary

Change in Starting The Conversation Scale: Whole Wheat

The Starting The Conversation Scale contains 6 items and asks respondents about the types of food they consumed in the past 30 days. The Whole Wheat subscale comprises 1 item in which respondents indicate how many cups of whole wheat, on average, they ate each day in the past 30 days. The total score is estimation of average cups of whole wheat consumed per day.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Starting The Conversation Scale: Whole Wheat-0.03 Cups/day
SMS InterventionChange in Starting The Conversation Scale: Whole Wheat0.08 Cups/day
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Blood-Glucose Testing subscale comprises 2 items rated on a scale from 0-7. The total Blood-Glucose Testing score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing Score-0.70 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing Score0.47 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Blood-Glucose Testing subscale comprises 2 items rated on a scale from 0-7. The total Blood-Glucose Testing score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing Score-0.14 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Blood-Glucose Testing Score0.10 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Exercise subscale comprises 2 items rated on a scale from 0-7. The total Exercise score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise Score0.89 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise Score1.56 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Exercise subscale comprises 2 items rated on a scale from 0-7. The total Exercise score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise Score0.20 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Exercise Score1.26 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Foot Care subscale comprises 2 items rated on a scale from 0-7. The total Foot Care score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care Score-0.17 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care Score0.07 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Foot Care subscale comprises 2 items rated on a scale from 0-7. The total Foot Care score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care Score0.00 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Foot Care Score-0.22 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The General Diet subscale comprises 2 items rated on a scale from 0-7. The total General Diet score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet Score0.09 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet Score1.74 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The General Diet subscale comprises 2 items rated on a scale from 0-7. The total General Diet score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet Score0.43 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - General Diet Score2.04 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Medication Adherence subscale comprises 3 items rated on a scale from 0-7. The total Medication Adherence score is the mean of the item responses and ranges from 0-21, with higher scores indicating better compliance.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence Score0.06 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence Score-0.03 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Medication Adherence subscale comprises 3 items rated on a scale from 0-7. The total Medication Adherence score is the mean of the item responses and ranges from 0-21, with higher scores indicating better compliance.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence Score-0.06 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Medication Adherence Score-0.46 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Specific Diet subscale comprises 2 items rated on a scale from 0-7. The total Specific Diet score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 3

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet Score-0.31 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet Score0.17 score on a scale
Secondary

Change in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet Score

The SDSCA measures the frequency of diabetes self-care activities over the previous week across five domains of self-care. The Specific Diet subscale comprises 2 items rated on a scale from 0-7. The total Specific Diet score is the mean of the item responses and ranges from 0-14, with higher scores indicating better compliance.

Time frame: Baseline, Month 6

ArmMeasureValue (MEAN)
Wait-list ControlChange in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet Score0.2 score on a scale
SMS InterventionChange in Summary of Diabetes Self-Care Activities (SDSCA) - Specific Diet Score0.59 score on a scale

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026