SMS texting for uncontrolled diabetes among persons experiencing homelessness: Study protocol for a randomized trial
SMS texting for uncontrolled diabetes among persons experiencing homelessness: Study protocol for a randomized trial
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DOI：
10.1016/j.cct.2023.107149
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发表时间：
2023-03-15
影响因子：
2.2
通讯作者：
Schoenthaler, Antoinette
中科院分区：
文献类型：
--
作者：
Asgary, Ramin;Beideck, Elena;Schoenthaler, Antoinette
背景资料：糖尿病（DM）在经历无家可归（PEH）的人中很常见，通常管理不充分，并带来巨大的成本。包括短信服务（SMS）在内的移动健康战略是可行的，可以接受的，并改善了对包括糖尿病在内的慢性病的控制。尽管移动的电话可访问性，但在PEH中尚未测试DM的SMS策略。我们提出了一个SMS战略可以提供更好的沟通，教育和信息管理，提高外展，促进护理协调，探讨护理障碍，并支持behaviorchanges.Methods和analysis：这种混合方法（随机对照试验和定性）的研究将在纽约市的庇护所诊所与社区组织合作实施，允许可持续性和可扩展性。目标1将评价为期6个月的SMS计划对DM管理的有效性，对比注意力控制对HbA1c变化的有效性，以及9个月时对DM不受控制的成人PEH患者（n = 100）的DM自我护理活动、药物和预约的依从性。将在0、3、6和9个月时测量结局。目的2将评估患者和供应商的态度，可接受性，并通过半结构化的采访与PEH（n = 20）和供应商（n = 10）的程序的经验。针对DM的短信策略从未在PEH中进行过测试，尽管有证据表明其有效性和PEH中移动的电话的使用。这项研究的结果将提供重要的经验数据，为循证策略提供信息，以避免个人痛苦和重大成本。它将对糖尿病和其他慢性病的控制产生更广泛的政策影响。
Background: Diabetes mellitus (DM) is common among persons experiencing homelessness (PEH), often inade-quately managed, and carries significant costs. mHealth strategies including short messaging service (SMS) texting have been feasible and acceptable, and improved control of chronic diseases including DM. SMS strategies for DM have not been tested among PEH despite the accessibility of mobile phones. We propose an SMS strategy could offer better communication, education, and information management; improve outreach; facilitate care coordination; explore barriers to care; and support behavior changes.Methods and analysis: This mixed-methods (RCT and qualitative) study will be implemented in shelter-clinics in New York City in collaboration with community organizations, allowing for sustainability and scalability. Aim 1 will evaluate the efficacy of a 6-month SMS program for DM management versus an attention control on changes in HbA1c and adherence to DM self-care activities, medications, and appointments at 9 months in adult PEH with uncontrolled DM (n = 100). Outcomes will be measured at 0, 3, 6, &9 months. AIM 2 will assess patients' and providers' attitudes, acceptability, and experience of the program through semi-structured interviews with PEH (n = 20) and providers (n = 10).Discussion: DM is not well-addressed among PEH. SMS strategies for DM have never been tested in PEH despite evidence of their effectiveness and access to mobile phones among PEH. Results from this study will provide important empirical data to inform evidence-based strategies to avert personal suffering and significant costs. It will have broader policy implications in control of DM and other chronic diseases.