AUTHOR=Azelton Kimberly R. , Crowley Aidan P. , Vence Nicholas , Underwood Karin , Morris Gerald , Kelly John , Landry Matthew J. TITLE=Digital Health Coaching for Type 2 Diabetes: Randomized Controlled Trial of Healthy at Home JOURNAL=Frontiers in Digital Health VOLUME=3 YEAR=2021 URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2021.764735 DOI=10.3389/fdgth.2021.764735 ISSN=2673-253X ABSTRACT=

Digital health coaching is an intervention for type 2 diabetes mellitus (T2DM) that has potential to improve the quality of care for patients. Previous research has established the efficacy of digital interventions for behavior change. This pilot study addresses a research gap in finding effective and accessible behavioral interventions for under-resourced individuals with T2DM. We examined the impact of Healthy at Home, a 12-week phone and SMS-based (short message service) digital health coaching program, on insulin resistance which is an upstream marker for T2DM progression. We compared this intervention to usual diabetic care in a family medicine residency clinic in a randomized controlled trial. Digital health coaching significantly improved participants' calculated Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) by −0.9 ± 0.4 compared with the control group (p = 0.029). This significance remained after controlling for years diagnosed with T2DM, enrollment in Medicaid, access to food, baseline stage of change, and race (p = 0.027). Increasing access to digital health coaching may lead to more effective control of diabetes for under-resourced patients. This study demonstrates the potential to implement a personalized, scalable, and effective digital health intervention to treat and manage T2DM through a lifestyle and behavioral approach to improve clinical outcomes (http://clinicaltrials.gov, NCT04872647).