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| | Component | Usability & feasibility testing | Randomized controlled trial |
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| Patient participants | Phone coaching | (i) Skill building exercise and type of family action assigned by round of usability testing
(a) Assertive communication to ask for a needed helpful action (Round 1)
(b) Assertive communication to stop/redirect an unwanted harmful action (Round 2)
(c) Problem solving to identify how family members can help overcome a barrier to goal completion (Round 3) | (i) Session 1 focuses on collaborative goal setting and brief skill building exercise (Family Behavior Observation) with homework to observe family actions
(ii) Coach and participant collaboratively chose whether to focus on a helpful or harmful family action for skill building
(iii) Coach chooses skill building exercise based on participant needs during sessions 2–5
(a) Assertive communication
(b) Problem solving
(c) Cognitive behavioral coping |
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| Patient participants | Text messages | Content |
(i) Goal assessment message and feedback assume a daily goal
Your goal was to walk 15 minutes each day. How many days did you meet this goal last week (Sun-Sat)? Reply with the number of days, 0–7.
(a) Feedback based on number of days goal was completed out of 7 days; success was identified as meeting goal 7 days | (i) Goal assessment message and feedback accommodate a goal for ≥4 days per week
Your goal was to walk 15 minutes 4 days. How many days did you meet this goal last week (Sun-Sat)? Reply with the number of days, 0–7.
(a) Feedback congratulated respondent for meeting the goal, 4–6 days, and challenged him/her to strive for 7 days next week |
| Functionality |
(i) Participants have 2 hours to respond to goal assessment text
(a) Feedback is tailored to participants’ response from the week in question and the prior week
(b) Nonresponse affects feedback for the week in question and the next week | (i) Participants have 4 hours to respond to goal assessment text
(a) Feedback is tailored to participants’ response from the week in question and if the participant responded the prior week, whether goal attainment improved/declined/was consistent
(b) Nonresponse only affects feedback for the week in question |
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| Support persons | Invitation & enrollment | (i) Participant given the option to invite a “family member” upon enrollment (by enrolling research assistant), only once | (i) Participant given option to invite a “support person” (SP) at end of each coaching session (by coach), multiple times
(a) Emphasized to participant that all SP involvement occurs via phone
(ii) Told SP all text messages are sent to all SPs in the study and are not selected based on anything the PP reported about the SP or their relationship |
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| Support persons | Text messages | Content |
(i) Some texts used language like “nagging” and “diabetes cop”
Do you examine Beth’s plate and nag them during meals? Think of more helpful ways to promote better eating besides being a diabetes cop.
Do you argue with Beth about her diabetes? Take a step back. Next time ask what you can do to help Beth make better health choices.
Your role as a loved one is to support Beth in meeting her health goal by asking how you can be helpful. Remember not to be the diabetes police! | (i) Avoided language that can be perceived as accusatory or offensive
Instead of asking Beth what she is doing to take care of her diabetes, ask what you can do to help.
Even if you disagree with Beth about her health, be gentle and find a way to help her reach her goals.
Support Beth by brainstorming together ways you can help her be successful in meeting her health goals. |
| Functionality |
| (i) Daily texts | (i) Three texts per week |
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