NYULMC CareSmarts Pilot

CareSmarts is a mobile diabetes program that provides self-management support and team-based
care management for people with diabetes through automated SMS messages. The program is a
theory-driven behavioral intervention designed to improve self-care through multiple
mediators, including cuing, education, self-efficacy, social support, and health beliefs.
Participants in the program receive educational and motivational text messages about
diabetes self-care, some prompts to engage in a particular action (for example, "Time to
check your blood sugar"), and some self-assessment questions (such as, "Do you need refills
of any of your medications?") to which the patient responds by texting. Participants'
responses to self-assessment questions are used to facilitate remote monitoring and care
management by the health care team. A response that is outside established parameters
triggers an alert. Using protocols, nurses respond to each alert by the next business day.

Inclusion Criteria:

- have a DRG Code of T2D, and be prescribed at least one oral T2D drug and/or insulin.

- must own an SMS capable mobile device and be willing to send and receive SMS messages
regarding T2D self-management.

- The participant's physician of record will have verified that his/her patient can
safely participant in an intervention study that targets an HbA1c <7%.

Exclusion Criteria:

- unable or unwilling to provide informed consent

- unable to participate meaningfully in an intervention that involves use of SMS
messages (e.g., due to uncorrected sight impairment, illiterate,
non-English-speaking)

- unwilling to accept randomization assignment

- pregnant, plans to become pregnant in the next 6 months, or who become pregnant
during the study

- gestational diabetes

- breastfeedling

- individuals who are institutionalized (e.g., in a nursing home or personal care
facility, or those who are incarcerated and have limited control over
self-management)