2790-LB: Tailored Text Messaging Intervention for Hispanic Adults with Type 2 Diabetes: A Pilot Randomized Controlled Study

Introduction and Objective: Hispanic adults with type 2 diabetes (T2D) in the US have higher mean HbA1c and lower rates of diabetes medication adherence than non-Hispanic White adults. We assessed feasibility and preliminary efficacy of a text message intervention to improve medication adherence and glycemic management. Methods: REACH-Español (REACH-Es) is a short message service (SMS) platform adapted from the English-language REACH intervention that addresses barriers to diabetes medication adherence and delivers diabetes self-care content. Hispanic adults (with Spanish-speaking preference) and T2D were randomized to REACH-Es or usual care. Primary outcomes were feasibility (recruitment rate ≥10%; retention rate ≥ 85%), acceptability (utility ≥7 on 0-10 scale; 2-way SMS response rate ≥ 80%), usability (≥85 on System Usability Scale), diabetes medication adherence (ARMS-D), and adherence barriers sum score. Secondary outcomes were diabetes self-efficacy and HbA1c at 3- and 6 months. Results: We enrolled 70 participants (70/81 eligible, 86% recruitment rate); 66 completed 6-month follow-up (94% retention). Mean age was 62 years; 61% were female, 57% had < high school education, 73% reported household income < $17,000. Mean baseline HbA1c was 8.5%. At 6 months, mean utility score was 9.9/10, SMS response rate 83.6%, usability score 90.4/100. Compared to usual care, HbA1c was lower in the REACH-Es arm at 3-months (-0.56 % (-1.07, -0.05), p=0.031) and 6 months (-1.00 % (-1.74, -0.26), p=0.008). There were no differences in ARMS-D, barrier scores, and self-efficacy in the intervention vs. usual care arms. Conclusion: REACH-Es has strong feasibility, high acceptability and usability, and resulted in a clinically meaningful reduction in HbA1c at 3- and 6 months among Hispanic adults with T2D. Disclosure J. Seiglie: None. L. Bernier Rivera: None. R. Crespo Trevino: None. A. Fremaint: None. R.M. Perez: None. S. Cromer: Other - Spouse is employee of Depuy Synthes; Current; Johnson & Johnson. A.E. Caballero: None. J. Miranda: None. D. Wexler: Other - Data Monitoring Committee; Ended; Novo Nordisk. Other - Data Monitoring Committee; Current; Amgen Inc. L.S. Mayberry: None.