Research Database
SMS texting for diabetes control among homeless persons
Ramin Asgary, MD
Institution:
The George Washington University
Grant Number:
11-21-ICTSHD-16
Type of Grant:
Clinical
Diabetes Type:
Type 2 Diabetes
Therapeutic Goal:
Manage Diabetes
Project Date:
-
Project Status:
active

Research Description

Homelessness is a widespread social problem. There are about 100 million homeless persons including 3.5 million Americans. Covid-19 has forced more Americans into the homelessness. Most homeless persons are from minorities. Cardiovascular risk factors such as type 2 diabetes and hypertension are as common among homeless persons as the general population. My team and I have documented that homeless persons are more than twice as likely to have uncontrolled diabetes compared to domiciled patients. Diabetes related hospitalization and emergency room visits are very high among homeless persons and contribute to the high cost of homelessness. But diabetes control strategies for homeless persons are not well-studied. General strategies for diabetes education and support to change behaviors and improve medication taking have improved diabetes control among domiciled patients. However these are not easily accessible to homeless persons. Most homeless persons have access to cellphones and text messaging and around 80% live in the shelters. This project, in close collaboration with a community organization that operates shelters in New York City, proposes to provide diabetes support to homeless persons in the shelters using text messaging to improve recommended diabetes self-care activities, medication taking, and attendance to medical appointments. The proposed study will make a valuable contribution to integrate effective text messaging strategies into the healthcare of homeless persons, making it possible to control diabetes among diabetic homeless adults and reduce related death and disabilities. The learning from this project will also be useful in the management of other chronic diseases among homeless persons.

Research Profile

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?

This project primarily relates to diabetes health services research with a focus on socio-behavioral aspects of diabetes care. The research explores interventions to address gaps in diabetes care at the intersection of social science, social determinants of health, and access to healthcare for vulnerable populations. This project provides opportunities for persons who experience homelessness to better manage their diabetes through behavioral supports that are provided by text messaging via cell phones. The findings from this study, if proven, will pave the way for more effective treatment of diabetes and better prevention of consequences of inadequately managed diabetes among marginalized populations.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

General strategies for diabetes education and support to change behaviors and improve medication taking have improved diabetes management among many patients. However, these strategies may not easily be accessible to everyone, especially people who struggle with a lot of social barriers. Most people have access to cell phones and text messaging. This project, in a community-based approach, provides diabetes support through text messaging to improve recommended diabetes self-care activities, medication taking, and attendance to medical appointments. The proposed study will make a valuable contribution to integrate effective text messaging strategies into the healthcare of persons with diabetes, making it possible to manage diabetes and reduce related death and disabilities. The learning from this project will also be useful in the management of other chronic diseases.

Why important for you, personally, to become involved in diabetes research? What role will this award play?

Diabetes is a chronic condition that causes significant death and disability for patients and enormously burdens the healthcare system. It contributes to many other serious health conditions including but not limited to cardiovascular diseases, kidney diseases, eye problems, and infections. As a clinician researcher I have witnessed the negative impact of inadequately managed diabetes among many of my own patients especially the ones from low socioeconomic background. There is a lack of evidence and data on best strategies to address diabetes management among underserved populations. I have extensive work experience with underserved populations including persons who experience homelessness. Therefore, I am well-positioned to use my experience to develop and evaluate strategies to address gaps in access to diabetes care among these populations. This award will help me evaluate innovative strategies to improve care for this very vulnerable population not only for diabetes but also other chronic conditions. It will provide me with the support needed to take my research to the next level and develop more effective interventions to address health disparities, domestically and internationally.

In what direction do you see the future of diabetes research going?

Increasingly there has been a recognition of the enormous human and financial cost of diabetes, nationally and globally. There are many areas to explore in diabetes care including genetics, individual and environmental factors, prevention strategies, treatment modalities, and health services and implementation research. I am optimistic that all these areas of diabetes research will not only expand but also inter-relate for synergy to address diabetes in a spectrum of care. In a shorter term, I’d imagine research focus will be on primary and secondary prevention strategies and assuring access to already established and evidence-based approaches in treating diabetes and averting its consequences.