Athena Philis-Tsimikas, Addie L Fortmann, Taylor Clark, Samantha R Spierling Bagsic, Emilia Farcas, Scott C Roesch, James Schultz, Todd P Gilmer, Job G Godino, Kimberly L Savin, Mariya Chichmarenko, Jennifer A Jones, Haley Sandoval, Linda C Gallo
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Changes in HbA1c (primary outcome), low-density lipoprotein-cholesterol, systolic blood pressure, and patient-reported outcomes were examined across 6 and 12 months, with the primary comparison being DD versus DD-Me (combined automated and telephonic).</p><p><strong>Results: </strong>Participants were 52.1 (±10.2) years old, 69.7% female, with HbA1c 9.3% (±1.6) at baseline. Across groups, there was a statistically significant improvement in HbA1c at 6 months (mean∆ per month = -0.17, 95% CI -0.20, -0.14; P < .001) and 12 months (mean∆ per month = -0.07, 95% CI -0.09, -0.05; P < .001). However, there were no time-by-group interaction effects indicating group differences in clinical outcomes across 6 or 12 months. The DD-Me groups showed greater improvements across time than the DD group for diabetes self-management behaviors.</p><p><strong>Conclusions: </strong>Static and adaptive digital interventions for Latine adults with type 2 diabetes had similar and clinically significant effects on HbA1c across 12 months. Simple digital approaches can be integrated within primary care-based chronic care models to reduce diabetes disparities.</p><p><strong>Clinicaltrials.gov registration: </strong>NCT03130699, Initial Release 04/24/2017, https://clinicaltrials.gov/ct2/show/NCT03130699?term=NCT03130699&draw=2&rank=1.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761693/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dulce Digital-Me: results of a randomized comparative trial of static versus adaptive digital interventions for Latine adults with diabetes.\",\"authors\":\"Athena Philis-Tsimikas, Addie L Fortmann, Taylor Clark, Samantha R Spierling Bagsic, Emilia Farcas, Scott C Roesch, James Schultz, Todd P Gilmer, Job G Godino, Kimberly L Savin, Mariya Chichmarenko, Jennifer A Jones, Haley Sandoval, Linda C Gallo\",\"doi\":\"10.1093/abm/kaae077\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare the effectiveness of a static, text-based diabetes education and support intervention (Dulce Digital, DD) versus a dynamic approach with personalized feedback and goal setting (Dulce Digital-Me, DD-Me) in improving diabetes outcomes.</p><p><strong>Design and methods: </strong>Comparative effectiveness trial in 310 Latine adults with poorly managed type 2 diabetes in a Federally Qualified Health Center in Southern California, randomized to DD, DD-Me-Auto (algorithm-driven text-based personalized feedback), or DD-Me-Tel (coach delivered personalized feedback). Changes in HbA1c (primary outcome), low-density lipoprotein-cholesterol, systolic blood pressure, and patient-reported outcomes were examined across 6 and 12 months, with the primary comparison being DD versus DD-Me (combined automated and telephonic).</p><p><strong>Results: </strong>Participants were 52.1 (±10.2) years old, 69.7% female, with HbA1c 9.3% (±1.6) at baseline. Across groups, there was a statistically significant improvement in HbA1c at 6 months (mean∆ per month = -0.17, 95% CI -0.20, -0.14; P < .001) and 12 months (mean∆ per month = -0.07, 95% CI -0.09, -0.05; P < .001). However, there were no time-by-group interaction effects indicating group differences in clinical outcomes across 6 or 12 months. 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引用次数: 0
摘要
目的：比较静态的、基于文本的糖尿病教育和支持干预（Dulce Digital， DD）与带有个性化反馈和目标设定的动态方法（Dulce Digital- me, DD- me）在改善糖尿病预后方面的有效性。设计和方法：在南加州一家联邦认证的健康中心，对310名管理不善的2型糖尿病拉丁裔成年人进行比较有效性试验，随机分为DD、DD- me - auto（算法驱动的基于文本的个性化反馈）或DD- me - tel（教练提供个性化反馈）。HbA1c（主要结局）、低密度脂蛋白-胆固醇、收缩压和患者报告结局的变化在6个月和12个月内进行了检查，主要比较的是DD与DD- me（自动和电话联合）。结果：参与者年龄为52.1（±10.2）岁，69.7%为女性，基线HbA1c为9.3%（±1.6）。各组患者6个月时HbA1c改善有统计学意义(平均每月∆= -0.17,95% CI -0.20, -0.14；结论：在12个月内，拉丁裔成人2型糖尿病患者的静态和适应性数字干预对HbA1c的影响相似且具有临床意义。简单的数字方法可以整合到以初级保健为基础的慢性保健模式中，以减少糖尿病的差异。clinicaltrials.gov注册：NCT03130699，首次发布于2017年4月24日，https://clinicaltrials.gov/ct2/show/NCT03130699?term=NCT03130699&draw=2&rank=1。
Dulce Digital-Me: results of a randomized comparative trial of static versus adaptive digital interventions for Latine adults with diabetes.
Objective: To compare the effectiveness of a static, text-based diabetes education and support intervention (Dulce Digital, DD) versus a dynamic approach with personalized feedback and goal setting (Dulce Digital-Me, DD-Me) in improving diabetes outcomes.
Design and methods: Comparative effectiveness trial in 310 Latine adults with poorly managed type 2 diabetes in a Federally Qualified Health Center in Southern California, randomized to DD, DD-Me-Auto (algorithm-driven text-based personalized feedback), or DD-Me-Tel (coach delivered personalized feedback). Changes in HbA1c (primary outcome), low-density lipoprotein-cholesterol, systolic blood pressure, and patient-reported outcomes were examined across 6 and 12 months, with the primary comparison being DD versus DD-Me (combined automated and telephonic).
Results: Participants were 52.1 (±10.2) years old, 69.7% female, with HbA1c 9.3% (±1.6) at baseline. Across groups, there was a statistically significant improvement in HbA1c at 6 months (mean∆ per month = -0.17, 95% CI -0.20, -0.14; P < .001) and 12 months (mean∆ per month = -0.07, 95% CI -0.09, -0.05; P < .001). However, there were no time-by-group interaction effects indicating group differences in clinical outcomes across 6 or 12 months. The DD-Me groups showed greater improvements across time than the DD group for diabetes self-management behaviors.
Conclusions: Static and adaptive digital interventions for Latine adults with type 2 diabetes had similar and clinically significant effects on HbA1c across 12 months. Simple digital approaches can be integrated within primary care-based chronic care models to reduce diabetes disparities.
期刊介绍：
Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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