Researchers conducted a three-arm randomized controlled trial involving 666 African-American adults with uncontrolled diabetes and multiple chronic conditions. These participants received care at 19 primary care practices in the Mid-South US region. The study compared three approaches: educational materials alone, educational materials with health coaching, and educational materials with text messaging.
All three groups showed significant improvements in their average HbA1c levels over 12 months. However, the group receiving text messages alongside education reported the largest increase in healthy eating days. This group added an average of 1.36 days per week of healthy eating compared to the education-only group. The other two approaches also increased healthy eating days but showed smaller gains.
Exercise behaviors remained similar across all groups, and no safety concerns were reported. The main reason to be careful is that these results apply specifically to African-American adults with uncontrolled diabetes and multiple chronic conditions. Readers should take from this that low-cost tools like text messaging can be effective when added to standard diabetes education in primary care settings.