We thank the participants who took part in this study as well as the staff at the primary care practices and diabetes clinics across New Zealand who referred their patients to the study; the National Institute for Health Innovation’s IT team for their work on the text message delivery system, and all those involved in the study design and set up; Coral Skipper, Louise Elia, Erana Poulsen, and Hamish Johnstone (Māori Advisory Group members); Aumea Herman (Pacific adviser); Joanna Naylor and Michelle Garrett (content development advisers); Richard Edlin (health economist); Mahalah Ensor (assistance with recruitment); Hannah Bartley, Rachel Sullivan, Anne Duncan, and Gillian Lockhart (research assistants); Michelle Jenkins and John Faatui (data management support); and Karen Carter and Angela Wadham (project management support).
‘I was very pleased to contact your service. I was feeling overwhelmed with my current situation however knew that I needed to get a diabetes test done. While I was waiting for my turn to be tested Susan welcomed me, helped my overwhelming feelings calm down, she was very approachable and understanding. Sandy followed through by assisting me with assurance that things were going to be okay and was very understanding. She encouraged that I seek more medical advice for my blood pressure results. She phoned my manager and found me a local GP that I could visit right away. I was very appreciative of these ladies and all the help, care and advice they gave me. Thank you so much!’
Only children aged <15 yr were included. Type 1 diabetes was diagnosed based on clinical features. All patients had elevated blood glucose at presentation: either a random measurement of ≥11.1 mmol/l and presence of classical symptoms, or fasting blood glucose ≥7.1 mmol/l. In addition, all patients met at least one of the following criteria: a) diabetic ketoacidosis; b) presence of at least two type 1 diabetes antibodies (to glutamic acid decarboxylase, islet antigen 2, islet cell, or insulin autoantibodies); or c) ongoing requirement for insulin therapy. Clinical and demographic data were prospectively recorded on all patients at each outpatient visit.
Eligible participants were randomised to either an intervention or control group in a 1:1 ratio. Randomisation was stratified by health district category (high urban or high rural/remote), diabetes type (1 or 2), and ethnicity (Māori and Pacific, or non-Māori/non-Pacific). The randomisation sequence was generated by computer programme using variable block sizes of two or four, and overseen by the study statistician. Following participant consent and completion of the baseline interview, the research assistant then randomised the participant to intervention or control, using the REDCap randomisation module. The REDCap randomisation module ensured that treatment allocation was concealed until the point of randomisation. Due to the nature of the intervention, participants were aware of their treatment allocation. Research assistants conducting the phone interviews were also aware of the treatment allocation. However, the objective primary outcome was measured by blinded assessors throughout the study period.
The message delivery was managed by our content management system, with messages sent and received through a gateway company to allow for participants to be registered with any mobile network. Sending and receiving messages was free for participants. The system maintained logs of all outgoing and incoming messages. Further details of the intervention can be seen in the published pilot study,28 and protocol.30
Interventions The intervention group received a tailored package of text messages for up to nine months in addition to usual care. Text messages provided information, support, motivation, and reminders related to diabetes self management and lifestyle behaviours. The control group received usual care. Messages were delivered by a specifically designed automated content management system.
Subway® is celebrating World Sandwich Day today and we're helping feed the hungry in our community! Last year, we donated over 90,000 meals to KiwiHarvest. With your help, we can feed even more this year. So, join the Subway® Live Feed and head to your local participating Subway® in Bay of Plenty. Buy a Sub. Get one FREE. AND Subway® will donate a meal to charity. Because everyone deserves a good feed. Find out more!