Cited by 15Diabetes Management and EducationMobile Health and mHealth ApplicationsDiabetes Management and Research

Glycemic outcomes of a family-focused intervention for adults with type 2 diabetes: Main, mediated, and subgroup effects from the FAMS 2.0 RCT

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Nelson, Lyndsay A., Spieker, Andrew J., Greevy, Robert A., Roddy, McKenzie K., LeStourgeon, Lauren M., Bergner, Erin M., El-Rifai, Merna, Aikens, James E. +3 more·2023·Diabetes Research and Clinical Practice

Published version of a preprint

Abstract

Aims Family/friend Activation to Motivate Self-care (FAMS) is a self-care support intervention delivered via mobile phones. We evaluated FAMS' effects on hemoglobin A1c (HbA1c) and intervention targets among adults with type 2 diabetes in a 15-month RCT.Methods Persons with diabetes (PWDs) were randomized to FAMS or control with their support person (family/friend, optional). FAMS included monthly phone coaching and text messages for PWDs, and text messages for support persons over a 9-month intervention period.Results PWDs (N = 329) were 52 % male, 39 % reported minoritized race or ethnicity, with mean HbA1c 8.6 ± 1.7 %. FAMS improved HbA1c among PWDs with a non-cohabitating support person (-0.64 %; 95 % CI [-1.22 %, -0.05 %]), but overall mean effects were not significant. FAMS improved intervention targets including self-efficacy, dietary behavior, and family/friend involvement during the intervention period; these improvements mediated post-intervention HbA1c improvements (total indirect effect -0.27 %; 95 % CI [-0.49 %, -0.09 %]) and sustained HbA1c improvements at 12 months (total indirect effect -0.19 %; 95 % CI [-0.40 %, -0.01 %]).Conclusions Despite improvements in most intervention targets, HbA1c improved only among PWDs engaging non-cohabitating support persons suggesting future family interventions should emphasize inclusion of these relationships. Future work should also seek to identify intervention targets that mediate improvements in HbA1c.

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Crossref · 10.1016/j.diabres.2023.110991

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Authors
Nelson, L. A., Spieker, A. J., Greevy, R. A., Roddy, M. K., LeStourgeon, L. M., Bergner, E. M., El-Rifai, M., Aikens, J. E., Wolever, R. Q., Elasy, T. A., & Mayberry, L. S.
Affiliations
  • Vanderbilt University Medical Center (US)
  • University of Michigan (US)
Corresponding author
Mayberry, Lindsay S.
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2023-12
Volume
206
Pages
110991
ISSN
0168-8227 (ISSN-L)
OpenAlex
W4388297107
Cited by
15
References
55
Citations by year
2026: 7 · 2025: 3 · 2024: 4 · 2023: 1
FWCI
3.05
Type
journal article
Language
en
Open access
Locations
  • Diabetes Research and Clinical Practice (acceptedVersion)
  • medRxiv (acceptedVersion, cc-by-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • PubMed Central (submittedVersion, cc-by-nd)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK119282)
  • National Center for Advancing Translational Sciences
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, family intervention, glycemic control, HbA1c, text messaging, self-care support, family involvement, mediation, self-efficacy, dietary behavior, diabetes self-management

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