Abstract
PREP-DC (Planning, Reflecting, and Engaging with Providers for Diabetes Care) is a multicomponent behavioral intervention aimed at promoting optimal health communication between adolescents and young adults (AYAs) with T1D and health care providers (HCPs). In the PREP-DC pilot, we examined engagement with text messaging and utilized AYA feedback to revise text messages for a randomized trial. AYAs with T1D>1 year (n=16; M age=18.8 years; 50% male; 44% Caucasian) participated in the pilot, consisting of 2 intervention sessions and 3 related text messages/week delivered between 2 T1D medical visits (∼16 weeks). The study team and an AYA stakeholder created a library of 72 text messages to reinforce T1D communication skills and self-care. Texts were sent via secure messaging platform. HCPs rated AYA communication at baseline and follow-up medical visits (∼16 weeks post-baseline) using the Independent Behaviors during Consultation Scale (IBDCS). A1c was taken from the medical chart. Participants received a mean of 45 texts. One text/week posed a question and encouraged AYA response (M=15.5 texts); 69% responded ≥1 text (M responses=4±4.2 texts). Intervention outcomes differed by text response. AYAs with no responses had worsening A1c (10.4% to 11.2%; p<.05) and stable HCP-rated communication (IBDCS; 20.8 to 20.0; p=ns) from baseline to follow-up. AYAs with ≥ 1 response had stable A1c (9.6% to 9.6%; p=ns) and improved HCP-rated communication (IBDCS; 19.6 to 24.9; p<.01) from baseline to follow-up. AYAs reported high satisfaction with text messages. Feedback was used to revise text messages, including new response prompts, graphic content (e.g., memes), and more message tailoring. Text messaging was a promising component of this intervention pilot, and an indicator of text message engagement was related to intervention response. Future studies should further examine engagement with text messages, including analytics on opening texts and message content associated with higher AYA response. Disclosure M. Monaghan: Research Support; Self; American Diabetes Association. C. Wong: None. R. Streisand: None. Funding American Diabetes Association/Pathway to Stop Diabetes (1-18-ACE-27 to M.M.); Children's National
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