656-P: Adapting a Personalized Text Messaging Intervention to Improve Diabetes Medication Adherence in a Spanish-Speaking Population

Introduction & Objective: Medication non-adherence is a key modifiable contributor to suboptimal glycemic management among Latino adults with type 2 diabetes, but tools that address commonly reported barriers to diabetes medication adherence in this population are lacking. REACH is a text messaging platform based on the Information-Motivation-Behavioral skills (IMB) model that addresses barriers to adherence and can improve both adherence and HbA1c but is only available in English. We aimed to identify barriers to diabetes medication adherence among Latino adults with type 2 diabetes to adapt REACH to REACH-Español.

Methods: Latino adults with type 2 diabetes were invited to participate in focus groups. First, we did a free listing discussion of barriers to diabetes medication adherence, then asked participants to rank 40 barriers to diabetes medication adherence according to personal relevance (“never,” ”sometimes,” or “always”). We identified the most prevalent barriers and categorized them according to the IMB model.

Results: A total of 18 participants attended one of three focus groups. Mean age was 63.3 years and 55.0% were female. Mean HbA1c was 8.3% and mean diabetes duration was 21 years. Among the top five barriers, 80% corresponded to the Information domain: brand medication better than generic, don’t understand purpose of diabetes medication, don’t understand dose changes, and doubt that medications will improve diabetes control or prevent complications.

Conclusions: Diabetes medication adherence barriers that relate to information gaps are common in this population and can inform tailored text messaging for this intervention to reduce barriers to adherence.