JMIR Publications

ABSTRACT

Background:

Latinos living in rural South Texas have higher prevalence of diabetes but their access to diabetes self-management education and support (DSMES) is limited.

Objective:

We aimed to test the feasibility of a Community Health Worker (CHW)-led, mHealth-based DSMES intervention to reduce disparities in accessing DSMES services in underserved rural Latino residents in South Texas.

Methods:

This 12-week single-arm pre-post trial was delivered by trained CHWs to 15 adults with type 2 diabetes. The intervention consisted of digital diabetes education, self-monitoring (SM), a cloud-based dashboard, and CHW support. Feasibility was evaluated as retention, actual intervention use, program satisfaction, and barriers to implementation. We also explored the intervention’s effect on weight loss and Hemoglobin A1C (HbA1c).

Results:

All 15 participants were Latino (mean age 61.87±10.67 years; 60% female). The retention rate at posttest was 93%. On average, participants completed 37 of 42 (87.5%) digital diabetes education lessons with 8 participants completing all lessons. Participants spent 89% of days step tracking, 78% food logging, 47% blood glucose SM, and 81% weight SM. The level of program satisfaction was high. On average, participants lost 7.8 ± 7.0 lbs. of body weight (p = 0.001), while HbA1c level remained unchanged from baseline (6.91 ±1.28%) to posttest (7.04 ± 1.66%; p = 0.668).

Conclusions:

A CHW-led mHealth-based intervention was feasible and acceptable to improve access to DSMES services for Latino adults living in rural communities. Future randomized controlled trials are needed to test intervention efficacy on weight loss and glycemic control.