Outreach Methods for Type 2 Diabetes Screening

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Type 2 diabetes

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to identify the most effective way to encourage screening for type 2 diabetes or prediabetes. Researchers are testing various methods, such as text messages, patient portal messages, and mailed letters, to determine which best motivates individuals to undergo screening. Early detection is crucial, as it can lead to better treatment options and lifestyle changes. Individuals who are overweight or obese and have not been diagnosed with type 2 diabetes may be suitable candidates for this study. As an unphased trial, it offers participants the chance to contribute to significant research that could enhance diabetes screening methods for all.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on screening methods for type 2 diabetes, so it's best to ask the trial organizers for more details.

What prior data suggests that these outreach methods are safe for increasing glycemic screening?

Research has shown that using messages through patient portals and text messages is generally safe and well-liked by people with type 2 diabetes. One study found that text messages effectively warned patients about high blood sugar levels. Patients appreciated these direct alerts and found them helpful. Another study demonstrated that text and email reminders supported diabetes management by encouraging regular blood sugar checks. These methods are easy to use and have not caused any significant side effects. Additionally, sending letters by mail is a common way to share health information and has not raised any safety concerns. Overall, these communication methods are well-accepted and have been used successfully in past research. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores new ways to encourage people with type 2 diabetes to get screened for their condition. Unlike traditional healthcare reminders that often rely on phone calls or in-person visits, this trial tests digital communication methods like text messages and patient portal notifications, along with mailed letters, to prompt screenings. The unique aspect is the combination and sequence of these methods to see which approach is most effective in motivating patients to take action. By finding the best way to reach individuals, the trial aims to improve early detection and management of type 2 diabetes, ultimately leading to better health outcomes.

What evidence suggests that this trial's outreach methods could be effective for increasing glycemic screening rates?

This trial will compare different outreach methods to encourage glycemic screening for type 2 diabetes. Research has shown that sending text messages can help people better control their blood sugar levels. In one study, participants' A1C levels, a measure of blood sugar, dropped by 1.04%. Those who received text messages also took their medication more regularly and checked their blood sugar more often. In this trial, some participants will receive initial and follow-up screening invitations via text messages.

Other participants will receive messages through patient portals, which studies suggest improve communication between patients and doctors, supporting ongoing diabetes care. Additionally, some participants will receive mailed letters, which have been found to encourage more people to attend diabetes-related appointments, leading to more screenings. Each of these methods aims to increase screening rates and early detection, which is important for managing or preventing type 2 diabetes. ^{6 7 8 9 10}

Who Is on the Research Team?

Obidiugwu K Duru, MD, MS

Principal Investigator

University of California, Los Angeles

Are You a Good Fit for This Trial?

This trial is for overweight or obese individuals who haven't been screened for type 2 diabetes (T2D) or prediabetes and don't already have T2D. Participants should not have had an A1c test in the past three years.

Inclusion Criteria

I am overweight or obese.

Exclusion Criteria

I have type 2 diabetes with a recent A1c test.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive glycemic screening invitations via text or patient portal, followed by a mailed letter if not screened within 60 days

60 days

Remote communication

Follow-up

Participants are monitored for receipt of hemoglobin A1c screening and complete an acceptability survey

90 days

What Are the Treatments Tested in This Trial?

Interventions

• Mailed letter
• Patient portal message
• Text message

Trial Overview The study tests different ways to encourage glycemic screening by randomly assigning participants to receive a mailed letter, a text message, or a patient portal message. It's part of research on how best to promote early detection and treatment of T2D.

How Is the Trial Designed?

Group I: Initial text, follow-up text, letter Experimental Treatment 2 Interventions

Participants are initially randomized to glycemic screening invitations by text, and then if they are not screened within 30 days, then they are re-rerandomized to another glycemic screening invitation by text. If they are still not screened in another 30 days then they receive a mailed letter encouraging glycemic screening.

Group II: Initial text, follow-up portal, letter Experimental Treatment 3 Interventions

Participants are initially randomized to glycemic screening invitations by text, and then if they are not screened within 30 days, then they are re-rerandomized to another glycemic screening invitation by patient portal. If they are still not screened in another 30 days then they receive a mailed letter encouraging glycemic screening.

Group III: Initial portal, follow-up text, letter Experimental Treatment 3 Interventions

Participants are initially randomized to glycemic screening invitations by patient portal, and then if they are not screened within 30 days, then they are re-rerandomized to another glycemic screening invitation by text. If they are still not screened in another 30 days then they receive a mailed letter encouraging glycemic screening.

Group IV: Initial portal, follow-up portal, letter Experimental Treatment 2 Interventions

Participants are initially randomized to glycemic screening invitations by patient portal, and then if they are not screened within 30 days, then they are re-rerandomized to another glycemic screening invitation by patient portal. If they are still not screened in another 30 days then they receive a mailed letter encouraging glycemic screening.

Group V: Usual care Active Control 1 Intervention

Patients do not receive any glycemic screening invitations

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Published Research Related to This Trial

A text messaging program (TMP) significantly improved glucose control and retinopathy screening rates in a study of 20 patients with uncontrolled type 2 diabetes over 3 months.

More than 70% of participants reported positive changes in their self-care behaviors, suggesting that using technology can effectively support diabetes management, especially for those with limited access to healthcare education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Text Messaging in the Patient-Centered Medical Home to Improve Glucose Control and Retinopathy Screening. Miller, JM., Phalen, AG., Crawford, A., et al.[2020]

Supplemental text messaging (SMS4PreDM) was appealing to participants, particularly younger individuals and those from underserved populations, but it did not significantly enhance attendance or weight loss outcomes in the in-person National Diabetes Prevention Program (NDPP).

The study involved 488 participants over a year, comparing those who received in-person NDPP classes with and without the SMS4PreDM support, highlighting the need for further research to find effective strategies for improving NDPP outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supplemental Text Message Support With the National Diabetes Prevention Program: Pragmatic Comparative Effectiveness Trial. Ritchie, ND., Gutiérrez-Raghunath, S., Durfee, MJ., et al.[2021]

A new trial is testing the effectiveness of SMS text messages designed to improve medication adherence in adults with type 2 diabetes, involving 958 participants over 12 months, aiming to reduce cardiovascular risk.

Preliminary feasibility studies indicate that these SMS messages are acceptable to patients and successfully influence medication adherence, setting the stage for this larger trial to assess their impact compared to usual care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting People With Type 2 Diabetes in the Effective Use of Their Medicine Through Mobile Health Technology Integrated With Clinical Care to Reduce Cardiovascular Risk: Protocol for an Effectiveness and Cost-effectiveness Randomized Controlled Trial. Farmer, A., Jones, L., Newhouse, N., et al.[2023]

A study involving 36 adult patients without diabetes found that participants were generally receptive to receiving text messages for HbA1c screening, indicating a potential for mobile health interventions to increase diabetes screening rates.

Key factors for improving engagement included using plain language, personalizing messages, and clearly outlining the steps for screening, as well as considering the patient's relationship with their healthcare provider.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient Perspectives on a Targeted Text Messaging Campaign to Encourage Screening for Diabetes: Qualitative Study. Lenoir, KM., Sandberg, JC., Miller, DP., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9878360/

Mailed Letter Versus Phone Call to Increase Diabetic ... The goal of this study was to evaluate the effectiveness of such patient engagement strategies (eg, calling, mailing letters, or both) in improving diabetes ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/36630160/

Mailed Letter Versus Phone Call to Increase Diabetic ... Outreach was conducted by administrative staff within the clinic. The primary outcome was booking an appointment for DR screening. Results: A ...

3. jmir.org jmir.org/2023/1/e37867/PDF

Mailed Letter Versus Phone Call to Increase Diabetic- ... Patients older than 18 years with type 1 or type 2 diabetes were randomized to one of the following 4 engagement strategies: phone call, mail, ...

4. cdc.gov cdc.gov/pcd/issues/2015/15_0251.htm

Wellness Coaching for People With Prediabetes The Diabetes Prevention Program study reported that a 58% reduction in incidence of type 2 diabetes was observed among adults with prediabetes ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S2772628224000049

Digital health outreach to promote postpartum screening ... Nationally, only 7% of insured individuals with GDM obtain the recommended OGTT by 12 weeks postpartum, and Black individuals with GDM are least likely to ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12373006/

A randomized study comparing patient portal and email ... In survey data collection, email contact is largely considered a less expensive, albeit less effective, mode of outreach compared to postal ...

7. jmir.org jmir.org/2025/1/e79413

Use of and Medical Decision-Making in Portal Messages ... Portal messages are helpful for patients with type 2 diabetes (T2D) to receive important medical advice for managing T2D, including medication ...

8. researchgate.net researchgate.net/publication/38029202_Computerized_Automated_Reminder_Diabetes_System_CARDS_E-Mail_and_SMS_Cell_Phone_Text_Messaging_Reminders_to_Support_Diabetes_Management

E-Mail and SMS Cell Phone Text Messaging Reminders ... This pilot and feasibility study compared two-way SMS cell phone messaging with e-mail reminders that were directed at encouraging blood glucose ...

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9890353/

Patient Perspectives on a Targeted Text Messaging ... Our findings suggest that patients may be receptive to text messages that alert them to a risk of having an elevated HbA 1c in direct-to-patient alerts that ...

10. ajmc.com ajmc.com/view/ajmc_09jul_derose_425to431

Automated Messaging to Improve Compliance With ... A randomized trial was conducted to compare the use of automated telephone calls and mailed letters versus a no-contact control group among 13,057 patients with ...