Enhancing mHealth Technology to Activate Chronic Care Patients

Multi-site phased study, conducted within the Military Health System that includes a user-centered design phase and a patient centered medical home (PCMH)-based feasibility trial.

In Phase I the investigators will assess both patient and clinician preferences and usability regarding the enhancement of the enabling technology capabilities for Type 2 diabetes chronic self-care management. The data from the experience will be coded and analyzed by the research team and the technology will be adapted accordingly before Phase II.

Phase II research is a single-blinded 12-month feasibility study that seeks to include the enabling technology to support diabetes self-care management with tailored behavioral messaging aimed at reinforcing and encouraging self-care behavior based on patients' readiness. We have included safety thresholds that alert patients and clinical team under certain conditions.

Inclusion criteria

• Men and women age 18 years or older,
• Ability to understand and read English,
• Be empanelled to one of the target PCMH sites, and
• Diagnosed with type 2 diabetes.

Exclusion criteria

• pregnant women,
• non-English speaking patients,
• receiving hospice care,
• active cancer and treatment with chemotherapy or radiation therapy,
• taking Coumadin,
• recipient of gastric bypass or similar procedure,
• diagnosis of uncontrolled hypothyroidism,
• known Cushing's syndrome,
• being treated with oral steroids,
• known liver disease,
• current diagnosis of cognitive impairments which would interfere with use of technology,
• congestive heart failure New York Heart Association class 3 or 4,
• inability to use a mobile device due to cognitive or physical impairments, and
• PAM® score = 4 during initial screening.