Transitioning From an In-Person Intervention to Augmented Text Messaging During COVID-19 in Mexican Americans With Prediabetes: The Starr County Diabetes Prevention Randomized Clinical Trial.
Sharon A Brown, Mary A Winter, Heather A Becker and 7 others
PMID 38454633WHAT IT FOUND
In Mexican Americans with prediabetes, the remote package of text messages, videos, activity trackers, problem-solving content, phone coaching, and $25 payments did not differ significantly from in-person groups on 24-month glucose, A1C, waist-to-hip, or lifestyle outcomes; BMI was lower than control.
Key findings
01At 24 months, the main physiological outcomes showed no statistically significant differences among the three cohorts.
02In a post-hoc BMI test, the text-message cohort had significantly lower BMI than the control cohort.
03Among participants who experienced both formats, preferences for the combined in-person and text-message format were 82% after the 5th message and 68% after the 10th message.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used only 140 participants in three small cohorts, and the paper says more complex analyses were inappropriate. The cohorts were not a clean randomized comparison of text messaging alone; the text-message group switched from in-person sessions during the COVID pause, and the all in-person group was a randomly selected subset of completers. The 24-month measurement period varied across cohorts because of the research pause, and analyses controlled for time between intervention completion and measurement. The significant BMI result came from a post-hoc test after variance was not equal, not from the main physiological comparison. The text-message cohort experienced COVID-related stress, and the paper says COVID may have affected outcome measures. The intervention included text messages, videos, activity trackers, problem-solving content, phone coaching, and a $25 incentive, so the contribution of any single component cannot be separated.
Declared interests
The authors declared no conflicts of interest. The supplied publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that text messaging alone improved diabetes prevention. The remote program also included videos, activity trackers, phone coaching, and problem-solving content, and the significant BMI result was a post-hoc comparison after the main physiological outcomes showed no statistically significant cohort differences.