Text messaging to engage friends/family in diabetes self-management support: acceptability and potential to address disparities

Objective: Explore acceptability of engaging family/friends in patients' type 2 diabetes (T2D) self-management using text messaging.

Materials and methods: Participants (N = 123) recruited from primary care clinics for a larger trial evaluating mobile phone support for T2D completed self-report measures and a hemoglobin A1c test and then had the option to invite an adult support person to receive text messages. We examined characteristics and reasons of participants who did/did not invite a support person, responses to the invitation, and feedback from patients and support persons.

Results: Participants were 55.9 ± 10.1 years old, 55% female, 53% minority, and 54% disadvantaged (low income, less than high school degree/GED, uninsured, and/or homeless). Participants who invited a support person (48%) were slightly younger, more likely to be partnered, and reported more depressive symptoms and more emergency department visits in the year prior to study enrollment as compared to participants who did not (all p <.05). Participants' reasons for inviting a support person included needing help and seeing benefits of engaging others, while reasons for not inviting a support person included concerns about being a "burden" and support person's ability or desire to text. Support persons reported the texts increased awareness, created dialogue, and improved their own health behaviors.

Discussion: Patients inviting a support person had higher need and thus may stand to benefit most. Most support persons were open to engagement via text messages.

Conclusion: Across race and socioeconomic status, text messaging may engage support persons to increase health-related support-particularly for patients with higher levels of need.

Trial registration: Clinicaltrials.gov NCT02409329.