Text to Move (TTM)Study

• physical activity [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  Physical activity will be assessed by step counts measured by an ActiHealth pedometer and compared between the study arms.
  
  

• Clinical outcome [ Time Frame: over 6 months (Day 1 and day 180) ] [ Designated as safety issue: No ]
  Will be assessed by pre and post HbA1c measurements
  
  
• Change in physical activity behaviors [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  This will be assessed by Pre and post stage of behavior change based on the Stages of Motivational Readiness for Change model of the TTM.
  
  
• Satisfaction with the program [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  This will be assessed using standardized Questionnaires at closeouts
  
  
• Engagement to program [ Time Frame: 6 months ] [ Designated as safety issue: No ]

  This will be measure quantitatively by:

  • number of days participant wore their pedometers in the study;
  • number of logins to the ActiHealth step count web portal;
  • percentage of messages a user responds to, in 2-way text messages
  
  

Patients are referred into a Diabetes Self-Management Education (DSME) Support Program at Massachusetts General Hospital by a primary care provider at the time of diagnosis or as needed to gain better knowledge, awareness and understanding of their disease. Majority of the patients in the DSME program experience favorable outcomes; however, in key areas of T2DM management such as physical activity and nutrition, fewer patients experience success with their behavior goals, owing to the higher level of motivation required, and our inability to provide more frequent individually tailored feedback and coaching. In addition, we have observed that patients' behavior change is not sustained over time after finishing the DSME program.

In the proposed study, the investigators intend to augment DSME's evidence-based approach with two key connected health cornerstones - objective data collection and targeted personalized feedback. Using these two tools, we hypothesize that patients will be able to acquire new behaviors much sooner than status quo, and also maintain them for longer. Also, the scalability of the mobile component of the innovation will help us offer this evidence-based program to a much larger pool of patients, contributing greatly to the overall quality of diabetes management at our hospital.

The research team at Center for Connected Health will recruit participants from a pool of patients with T2DM who are participating in or who have gone through the DSME program at MGH Chelsea, MGH Revere or MGH Charlestown. These practices represent the most medically under served areas and serve low-income population. All of these practices have received recognition from the American Diabetes Association as having high-quality diabetes self-management education programs that meet the National Standards for Diabetes Self-Management Education.

120 participants will be enrolled and randomly assigned to one of the two groups.