339-OR: Yo Puedo! A Self-Management Group and mHealth Program for Low-Income Adults with Type 2 Diabetes in Mexico City

The purpose of this study was to evaluate the preliminary efficacy of a self-management group + mHealth program (Yo Puedo!) on clinical (A1C, BP, BMI), self-management (diet, exercise, blood glucose monitoring), depressive symptom, and self-efficacy outcomes in adults with type 2 diabetes (T2D) at Seguro Popular clinics in Mexico City. Participants were randomly assigned to treatment (n=26) or wait-list control groups (n=21) with data collected at 3 and 6 months. The Yo Puedo! Program included 7 weekly sessions and 6 months of daily text messages. Descriptive statistics and generalized linear mixed model (GLMM) with random intercept were calculated. Adults with T2D were 55.5 years of age (±8.6), 68% female, 59% married/partnered, 88.6% overweight/obese, 50% lived in moderate/severe food insecure households, 35.7% had increased depressive symptoms, and 80% had A1C above 7.0%. Mean duration of T2D since diagnosis was 11.5 years (±7.1). There were no between-group differences on baseline characteristics. There was 89% attendance at sessions and 6% attrition at 6 months. Group by time effects were seen in blood glucose monitoring (p<.01), diabetes self-efficacy (p<.04); with a trend for lower A1C in the intervention group at 6 months (-1.76% in treatment group vs. -.97 in control group, p=.08). Time effects for the intervention group included improved diet, exercise, blood glucose monitoring, diabetes self-efficacy, depressive symptoms and A1C at 6 months (p<.05). Adults with T2D in Mexico City positively responded to the Yo Puedo! group + mHealth program with improvements in self-management, depressive symptoms, self-efficacy, and A1C. Empowering patients with T2D self-management skills can improve key behaviors, mental health and blood glucose outcomes in vulnerable populations. A fully powered clinical trial is warranted.