Research Article

Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative

Table 1

Representative text messages across various topics and message types. Note that all five message types are used for each topic area. This table gives examples of some of these types for each topic.

TopicMessage typeExample text message

MedicationEducationTo get the most out of your medicines, you need to take them as prescribed and on time, every day. Even if you are not feeling sick.
PromptReminder: Time for your medicine!
FeedbackReminder: Think about the last time you didn't take your medications. What happened? Think about what you can do to prevent it from happening again.
AssessmentIn the last 7 days how many days did you take all of your diabetes medications?

Glucose MonitoringEducationA good blood sugar within two hours after eating is less than 180 mg/dL. A good fasting (before breakfast) blood sugar is 80 to 125 mg/dL
EncouragementMonitoring blood sugars is not just so your doctor knows how you are doing. Glucose monitoring is a tool for YOU to know how you are doing.
Feedback 7 for 7, perfect job! (in response to self-report of perfect adherence to glucose monitoring)

NutritionEducationCorn and potatoes may be vegetables, but they are also starches that can increase your blood sugar. Stick to non-starchy vegetables like spinach and carrots.
TipIf it's not in your kitchen, you probably won't eat it. Avoid temptation by not keeping desserts or unhealthy snacks in the house.
EncouragementDeveloping a tasty but healthy food plan with diabetes can be hard. Diabetes educators can help. Do you want to meet with one? (yes/no)

Foot CareEducationIncreased blood sugars can cause nerve damage to the foot and decrease circulation. Over time this can lead to pain, infection, and other foot problems.
PromptReminder: Check your feet every day. You should look between the toes and bottoms of your feet for cuts, cracks, or anything else out of the usual.
TipReminder: Make a daily foot check part of your routine. Do it as you step out of the shower or when you take your shoes off at the end of the day.

ExerciseEducationDid you know that experts recommend moderate physical activity for at least 30 minutes 4 times per week? (yes/no)
TipLifting small weights at home or while you jog can build muscle and lower your blood sugars. No weights? Use a can of vegetables!
EncouragementIt doesn't take hours of sweat-soaked exercise to get the benefits of exercise, even short period of gentle exercise can do a lot!

Living with a Chronic IllnessEducation “Health Navigation” moduleTip: Your clinic has a way to see urgent patients the same day or within 48 hours. When you are not feeling well, the emergency room is not your only option.
Education “Dealing with Stress”Tip: Did you know that stress increases your blood sugars? In fact, not only can stress increase your sugars but high sugars can also increase your stress.
Encouragement “Social Support”Tip: Everyone feels bad about their diabetes from time to time, even if they have had it for a while. It's what you do with those feelings that count.