Introduction and Objective: One static and two adaptive, personalized type 2 diabetes (T2D) education and support mHealth interventions recently showed comparable effectiveness in reducing A1c among low-income Latine adults with T2D. However, as the delivery of adaptive components was contingent on engagement [i.e., participants’ completion of ecological momentary assessments (EMA)], those who responded to fewer EMAs received less personalized feedback. This secondary analysis evaluates whether mHealth engagement moderates A1c outcomes.Methods: N = 310 Latine T2D adults with A1c ≥ 8% in a Federally Qualified Health Center were randomized to Dulce Digital (DD; static education and support messaging), DD-Me-Auto (DD + algorithm driven text based feedback), or DD-Me-Tel (DD + coach delivered feedback). To test moderation of 6-month A1c by engagement, its main effect and interactions with DD-Me-Auto and DD-Me-Tel (vs. DD) were added to the published outcome model, controlling for age, gender, language, employment.Results: Participants were 52 (±10) years old, 70% female, M baseline A1c = 9.3% (±1.6). Engagement moderated the effect of DD-Me-Auto, b = -0.5, 95% CI [-1.0,-0.1], p =.02, with more engagement linked to greater A1c improvements in DD-Me-Auto vs. DD (Fig. 1).Conclusion: Adding personalized, automated feedback to static education and support interventions may enhance outcomes for highly engaged Latine adults.
E.C. Soriano: None. S.R. Spierling Bagsic: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc. Research Support; Dexcom, Inc. Advisory Panel; Lilly Diabetes. Research Support; Lilly Diabetes. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Medtronic, Sanofi. A.L. Fortmann: None. T. Clark: None. E. Farcas: None. S. Roesch: None. J.H. Schultz: None. L. Gallo: None.
National Institute of Diabetes and Digestive and KidneyDiseases of the National Institutes of Health (R01DK112322), National Center for AdvancingTranslational Sciences (UL1TR002550), the New YorkCenter for Diabetes Translational Research (P30 DK111022)
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