title: The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes.
abstract: Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n= 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Lindsay Satterwhite
authors.identifier: 0000-0002-0654-4151
authors.initials: LS
authors.lastname: Mayberry
authors.affiliation: Department of Psychology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Berg
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Kryseana J
authors.initials: KJ
authors.lastname: Harper
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
mesh_terms: D000328:Adult; D032721:Adult Children; D001741:Black or African American; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000628:therapy*; D005190:Family; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods; D011203:Poverty; D012648:Self Care; D012944:Social Support; D018454:Spouses; D017216:Telemedicine / Q000379:methods*; D060145:Text Messaging; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human