title: Mobile phone-based video messages for diabetes self-care support.
abstract: BACKGROUND
  This study examined whether mobile phone-based, one-way video messages about diabetes self-care improve hemoglobin A1c (A1C) and self-monitoring of blood glucose (SMBG).
  
  
  METHODS
  This was a 1-year prospective randomized trial with two groups. The active intervention lasted 6 months. The study enrolled 65 people with A1C >8.0% who were established (>6 months) patients in the endocrinology clinics of the Walter Reed Health Care System. Participants were randomized to receive "usual care" or self-care video messages from their diabetes nurse practitioner. Video messages were sent daily to cell phones of study participants. Hemoglobin A1c and SMBG data were collected at 0, 3, 6, 9, and 12 months.
  
  
  RESULTS
  Participants who received the messages had a larger rate of decline in A1C than people who received usual care (0.2% difference over 12 months, adjusting for covariates; p = .002 and p = .004 for the interaction between time and group and for the quadratic effect of time by group, respectively). Hemoglobin A1c decline was greatest among participants who received video messages and viewed >10 a month (0.6% difference over 12 months, adjusting for covariates; p < .001 for the interaction between time and group and the quadratic effect). Self-monitoring of blood glucose metrics were not related to the intervention.
  
  
  CONCLUSIONS
  A one-way intervention using mobile phone-based video messages about diabetes self-care can improve A1C. Engagement with the technology is an important predictor of its success. This intervention is simple to implement and sustain.
authors.affiliation: Department of Endocrinology and Metabolism, Walter Reed National Military Medical Center, Bethesda, Maryland 20889, USA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Bell
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Fonda
authors.forename: M Susan
authors.initials: MS
authors.lastname: Walker
authors.forename: Virginia
authors.initials: V
authors.lastname: Schmidt
authors.forename: Robert A
authors.initials: RA
authors.lastname: Vigersky
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000451:nursing; D040421:Cell Phone; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009722:Nurse Practitioners; D010353:Patient Education as Topic; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human