We recruited participants across clinic sites in and around Nashville, Tennessee, including 13 FQHC locations and 3 Vanderbilt University Medical Center primary care locations. Recruitment strategies included the use of flyers, interest cards, referrals from clinic staff, mailing opt-in or opt-out letters (depending on clinic preference) to patients identified through the electronic health record (EHR) with follow-up calls, and in-person contact with patients in clinic waiting rooms or at clinic and community events. We oversampled patients who are racial/ethnic minorities and those who have low SES in several ways. First, our goal was to recruit at least 200 participants from FQHCs which serve uninsured or underinsured patients.
Second, when recruiting from Vanderbilt clinics, we prioritized the recruitment of patients with public health insurance (eg, TennCare [Medicaid], Medicare) only and/or who were racial/ethnic minorities.
Eligible participants were at least 18 years of age, had a diagnosis of T2D (both self-reported and confirmed either in the EHR or by a provider), were currently prescribed a daily diabetes medication (oral, insulin, and/or noninsulin injectables) and responsible for taking their diabetes medications (ie, without assistance from a caregiver), owned a cell phone with text messaging capability, received care at one of the participating clinics, and could speak and read in English. We excluded participants whose most recent HbA1c value within 12 months was <6.8% to ensure room to lower HbA1c and detect intervention effects (ie, avoid floor effects). In addition, because participants assigned to FAMS receive phone coaching, we excluded patients who had auditory limitations or an inability to orally communicate, as determined by trained research assistants (RAs). Patients who failed a brief cognitive screener [41 (link)] were excluded to help ensure accuracy of the measures and data integrity.
Finally, because all participants receive and are asked to interact using text messages, we excluded patients who were unable to receive, read or send text messages after demonstration by an RA (some participants with visual limitations were able to text and were therefore enrolled). We did not exclude participants based on comorbidities.
Second, when recruiting from Vanderbilt clinics, we prioritized the recruitment of patients with public health insurance (eg, TennCare [Medicaid], Medicare) only and/or who were racial/ethnic minorities.
Eligible participants were at least 18 years of age, had a diagnosis of T2D (both self-reported and confirmed either in the EHR or by a provider), were currently prescribed a daily diabetes medication (oral, insulin, and/or noninsulin injectables) and responsible for taking their diabetes medications (ie, without assistance from a caregiver), owned a cell phone with text messaging capability, received care at one of the participating clinics, and could speak and read in English. We excluded participants whose most recent HbA1c value within 12 months was <6.8% to ensure room to lower HbA1c and detect intervention effects (ie, avoid floor effects). In addition, because participants assigned to FAMS receive phone coaching, we excluded patients who had auditory limitations or an inability to orally communicate, as determined by trained research assistants (RAs). Patients who failed a brief cognitive screener [41 (link)] were excluded to help ensure accuracy of the measures and data integrity.
Finally, because all participants receive and are asked to interact using text messages, we excluded patients who were unable to receive, read or send text messages after demonstration by an RA (some participants with visual limitations were able to text and were therefore enrolled). We did not exclude participants based on comorbidities.
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