Overview
This 12-month pilot tests a nurse-led, app-based intervention to improve diabetes self-management for Medicaid patients. It includes MyChart messaging to give education, phone help on problem-solving with clinicians, and using a diabetes app to track data. The study aims to enhance self-management behaviors through health technology.
Description
Guided by the Self- and Family Management Framework, which specifies facilitators and barriers to self- management behaviors, this project tests strategies for delivering virtual diabetes care to help Medicaid patients and clinicians use health information technology to support self-management behaviors. It is a 12-month pilot nurse-led, app-based behavioral intervention consisting of three evidence-based interventions: (1) education on A1C results and goal-setting via MyChart, the Epic electronic health record's patient portal; (2) a problem-solving action plan developed collaboratively by clinicians and patients; and (3) remote monitoring via mySugr, a top- rated diabetes app, to track blood glucose and identify the need for treatment adjustments.
Eligibility
Inclusion Criteria:
- A1C \>7 for age 18-64, A1C\>8 for age 65 or older within 12 months prior baseline
- A1C\>7 for age 18-64, A1c\>8 for age 65 or older at baseline
- Medicaid recipient or dual Medicaid and Medicare recipient
- Age 18 or older
- Type 2 diabetes
- On insulin therapy
- Owning and using Android or iOS smartphone for at least 6 months
- English proficiency
- Adequate vision to read text messages on their current smartphone
- Smartphone use proficiency. Smartphone proficiency will be self-reported and determined by telephone as the ability to use a smartphone in ways other than emailing, texting, and making phone calls.
Exclusion Criteria:
- Pregnancy
- Patients with cognitive impairment who will be screened with the Six-Item Screener to Identify Cognitive Impairment Among Potential Research Subjects.
