Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025
Dulce Digital-Me: results of a randomized comparative trial of static versus adaptive digital interventions for Latine adults with diabetes.
СтатьяРандомизированное исследованиеСравнительное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Philis-Tsimikas Athena, Fortmann Addie L, Clark Taylor, Spierling Bagsic Samantha R, Farcas Emilia, Roesch Scott C, Schultz James, Gilmer Todd P, Godino Job G, Savin Kimberly L, Chichmarenko Mariya, Jones Jennifer A, Sandoval Haley, Gallo Linda C
Аннотация
OBJECTIVE: To compare the effectiveness of a static, text-based diabetes education and support intervention (Dulce Digital, DD) versus a dynamic approach with personalized feedback and goal setting (Dulce Digital-Me, DD-Me) in improving diabetes outcomes.
DESIGN AND METHODS: Comparative effectiveness trial in 310 Latine adults with poorly managed type 2 diabetes in a Federally Qualified Health Center in Southern California, randomized to DD, DD-Me-Auto (algorithm-driven text-based personalized feedback), or DD-Me-Tel (coach delivered personalized feedback). Changes in HbA1c (primary outcome), low-density lipoprotein-cholesterol, systolic blood pressure, and patient-reported outcomes were examined across 6 and 12 months, with the primary comparison being DD versus DD-Me (combined automated and telephonic).
RESULTS: Participants were 52.1 (±10.2) years old, 69.7% female, with HbA1c 9.3% (±1.6) at baseline. Across groups, there was a statistically significant improvement in HbA1c at 6 months (mean∆ per month = -0.17, 95% CI -0.20, -0.14; P < .001) and 12 months (mean∆ per month = -0.07, 95% CI -0.09, -0.05; P < .001). However, there were no time-by-group interaction effects indicating group differences in clinical outcomes across 6 or 12 months. The DD-Me groups showed greater improvements across time than the DD group for diabetes self-management behaviors.
CONCLUSIONS: Static and adaptive digital interventions for Latine adults with type 2 diabetes had similar and clinically significant effects on HbA1c across 12 months. Simple digital approaches can be integrated within primary care-based chronic care models to reduce diabetes disparities.
CLINICALTRIALS.GOV REGISTRATION: NCT03130699, Initial Release 04/24/2017, https://clinicaltrials.gov/ct2/show/NCT03130699?term=NCT03130699&draw=2&rank=1.
DESIGN AND METHODS: Comparative effectiveness trial in 310 Latine adults with poorly managed type 2 diabetes in a Federally Qualified Health Center in Southern California, randomized to DD, DD-Me-Auto (algorithm-driven text-based personalized feedback), or DD-Me-Tel (coach delivered personalized feedback). Changes in HbA1c (primary outcome), low-density lipoprotein-cholesterol, systolic blood pressure, and patient-reported outcomes were examined across 6 and 12 months, with the primary comparison being DD versus DD-Me (combined automated and telephonic).
RESULTS: Participants were 52.1 (±10.2) years old, 69.7% female, with HbA1c 9.3% (±1.6) at baseline. Across groups, there was a statistically significant improvement in HbA1c at 6 months (mean∆ per month = -0.17, 95% CI -0.20, -0.14; P < .001) and 12 months (mean∆ per month = -0.07, 95% CI -0.09, -0.05; P < .001). However, there were no time-by-group interaction effects indicating group differences in clinical outcomes across 6 or 12 months. The DD-Me groups showed greater improvements across time than the DD group for diabetes self-management behaviors.
CONCLUSIONS: Static and adaptive digital interventions for Latine adults with type 2 diabetes had similar and clinically significant effects on HbA1c across 12 months. Simple digital approaches can be integrated within primary care-based chronic care models to reduce diabetes disparities.
CLINICALTRIALS.GOV REGISTRATION: NCT03130699, Initial Release 04/24/2017, https://clinicaltrials.gov/ct2/show/NCT03130699?term=NCT03130699&draw=2&rank=1.