Text to Move (TTM)Study

Patients are referred into a Diabetes Self-Management Education (DSME) Support Program at
Massachusetts General Hospital by a primary care provider at the time of diagnosis or as
needed to gain better knowledge, awareness and understanding of their disease. Majority of
the patients in the DSME program experience favorable outcomes; however, in key areas of
T2DM management such as physical activity and nutrition, fewer patients experience success
with their behavior goals, owing to the higher level of motivation required, and our
inability to provide more frequent individually tailored feedback and coaching. In addition,
we have observed that patients' behavior change is not sustained over time after finishing
the DSME program.

In the proposed study, the investigators intend to augment DSME's evidence-based approach
with two key connected health cornerstones - objective data collection and targeted
personalized feedback. Using these two tools, we hypothesize that patients will be able to
acquire new behaviors much sooner than status quo, and also maintain them for longer. Also,
the scalability of the mobile component of the innovation will help us offer this
evidence-based program to a much larger pool of patients, contributing greatly to the
overall quality of diabetes management at our hospital.

The research team at Center for Connected Health will recruit participants from a pool of
patients with T2DM who are participating in or who have gone through the DSME program at
MGH Chelsea, MGH Revere or MGH Charlestown. These practices represent the most medically
under served areas and serve low-income population. All of these practices have received
recognition from the American Diabetes Association as having high-quality diabetes
self-management education programs that meet the National Standards for Diabetes
Self-Management Education.

120 participants will be enrolled and randomly assigned to one of the two groups.

Inclusion Criteria:

- Meet the following eligibility criteria of the Massachusetts General Hospital's DSME
program

- Adults over the age of 18 years.

- HbA1c over 7.0%

- All newly diagnosed and returning patients with a diagnosis of T2DM participating in
or who have gone the DSME program at MGH Chelsea, MGH Revere or MGH Charlestown will
be offered enrollment in the study.

- Must be willing to attend initial and close-out study visits

- Willingness to receive a maximum of 60 text messages/month for 6 months on their
personal cellular phone.

- PC computer with internet access

- Fluency in English or Spanish (spoken and written)

Exclusion Criteria:

- Disability, medical or surgical condition preventing or precluding moderate physical
activity.

- Significant cognitive deficits.