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The Impact of an Adaptive mHealth Intervention on Improving Patient-Provider Health Care Communication: Secondary Analysis of the DIAMANTE Trial

L. Leng, Marvyn R. Arévalo Avalos, A. Aguilera, Courtney R. Lyles

JMIR mHealth and uHealth, 2025

195 participants · 22 citations

Abstract

Abstract Background Depression and diabetes are highly comorbid conditions and are significant causes of global disability, particularly among individuals with low income or those from racial or ethnic minority backgrounds. While digital interventions offer promise for managing these chronic conditions (such as via lifestyle modification), there is also emerging evidence suggesting that digital support may strengthen or complement existing health care relationships, particularly by improving patient perceptions of communication and connection with their health care providers. Objective This study aimed to examine the impact of an adaptive mobile health (mHealth) texting-based intervention on patient ratings of communication with their health care providers among individuals with diabetes and depressive symptoms. Methods This study used data from the DIAMANTE (Diabetes and Mental Health Adaptive Notification Tracking and Evaluation) trial, a prospective, randomized controlled trial that varied SMS text messaging strategies to encourage physical activity to support both mental and physical health for patients with diabetes and depression. Patients were recruited from safety-net clinics in San Francisco and through social media during the COVID-19 pandemic, and were randomized into three trial arms: (1) personalized SMS text messaging about physical activity via an adaptive learning algorithm, (2) randomly selected SMS text messaging about physical activity, and (3) a control…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 195 participants or records.

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