SMS texting for uncontrolled diabetes among persons experiencing homelessness: Study protocol for a randomized trial

Authors

Ramin Asgary, George Washington University, Washington, DC 20052, USA & Icahn School of Medicine at Mount Sinai, New York, NY 10021, USA. Electronic address: ga263@columbia.edu.
Elena Beideck, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. Electronic address: ebeideck@bidmc.harvard.edu.
Rosanna Naderi, George Washington University, 950 New Hampshire Ave, Washington, D.C. 20052, USA.
Antoinette Schoenthaler, Department of Population Health, New York University School of Medicine, New York, NY 10016, USA. Electronic address: antoinette.schoenthaler@nyulangone.org.

Document Type

Journal Article

Publication Date

3-12-2023

Journal

Contemporary clinical trials

Volume

128

DOI

10.1016/j.cct.2023.107149

Keywords

Diabetes mellitus; Health disparities; Homeless; RCT; SMS; mHealth

Abstract

BACKGROUND: Diabetes mellitus (DM) is common among persons experiencing homelessness (PEH), often inadequately 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.

APA Citation

Asgary, Ramin; Beideck, Elena; Naderi, Rosanna; and Schoenthaler, Antoinette, "SMS texting for uncontrolled diabetes among persons experiencing homelessness: Study protocol for a randomized trial" (2023). GW Authored Works. Paper 2596.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2596

Department

Global Health