The study describes the development and usability testing of REACH (Rapid Education/Encouragement And Communications for Health), a tailored text-messaging intervention designed to improve self-care adherence among disadvantaged adults with type 2 diabetes. REACH was developed using an evidence- and theory-based approach and was designed to address individual barriers to diabetes self-care. Thirty-six adults with type 2 diabetes recruited from Federally Qualified Health Centers participated in three rounds of usability testing. Over two weeks, participants received daily text messages assessing and promoting self-care, including tailored messages addressing their individual adherence barriers, as well as weekly adherence feedback. Participants responded to 96% of assessment messages and rated the messages highly for ease of understanding and helpfulness. Feedback gathered during iterative testing was used to improve message content, technical functionality, and study enrollment procedures. The study demonstrated the importance of incorporating user feedback when developing technology-based interventions for underserved populations with type 2 diabetes.
Publications
August 17, 2026