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The Connected2Care Project team at NYU Langone engages patients who have type 2 diabetes to take an active role in managing their disease through its iMatter2 study.

iMatter2 Study Goal

iMatter (Investigating an mHealth Texting Tool for Embedding Patient-Reported Data into Diabetes Management) was a mobile health research project funded by the Agency for Healthcare Research and Quality (AHRQ), led by Antoinette M. Schoenthaler, EdD, designed to evaluate the effect of a technology-based patient-reported outcomes (PRO) tool for the care of patients with type 2 diabetes. iMatter used text messaging to capture PROs such as medication and dietary adherence, physical activity, and quality of life in real time, and summarized the data into a personal journal report paired with motivational messages to encourage healthy behaviors in patients.

Building from the success of that program, iMatter2 (An AI-Driven Approach to Supercharge a Novel Digital Patient-Reported Outcomes Tool for Diabetes Management) has been funded by AHRQ to continue use of text messaging to capture patient PROs, but now also uses a ChatGPT-based chatbot to send motivational messages based on PRO responses, educational resources, and appointment reminders to patients. Patients may ask the chatbot questions related to their diabetes management, including suggestions for healthy recipes, tips for better quality sleep, exercise suggestions, and how to adhere to their medications. The Connected2Care team curated an in-depth, comprehensive “knowledge base” around each PRO and general diabetes management to feed into ChatGPT, so patients can receive evidence-based suggestions and motivational messages at appropriate literacy levels during two-way conversations with the chatbot. Through the 12 months of participation, iMatter2 participants receive free home A1c test kits to submit their home A1c at baseline, 3-, 6-, and 12-months. Additionally, iMatter2 includes a custom-built health dashboard that displays visualizations of patient PROs and engagement measures to encourage participation and motivation of healthy behavior changes for patients, and similar summaries displayed in a provider-facing dashboard to help facilitate richer communication on their patients’ diabetes management during their regular visits.

The findings of this research will have important population health value by identifying the most effective way to collect and monitor PROs in patients’ daily lives and as part of routine care to strengthen their relationships with their providers and improve their management of diabetes.

iMatter2: Diabetes

In this project, we are evaluating the effect of mobile health program called iMatter2 for care of patients who have uncontrolled type 2 diabetes. The iMatter2 program uses text messaging to capture PRO data on each patient’s personal health goal, medication adherence, diet, sleep quality, physical activity, and perceived control over their diabetes. The system also enhances patient engagement through data-driven feedback and motivational messages sent via a two-way conversational ChatGPT-based “chatbot” and creates data visualizations in a health dashboard accessible directly to patients and to their provider. The dashboard includes key insights and evidence-based recommendations to help patients reflect on changes in their responses over time, and to help them better manage their type 2 diabetes.

Who Can Participate?

People who have a diagnosis of type 2 diabetes and have an HbA1c greater than seven documented in the electronic health record on two clinic visits in the past year may qualify to join this study. We plan to enroll 373 patients who have uncontrolled type 2 diabetes throughout the network of Family Health Centers and Faculty Group Practices at NYU Langone. Half of these patients will participate in the iMatter2 program, and the other half will continue with their usual care (UC).

What Does the iMatter2 Study Involve?

The study involves a brief screening/consent and surveys. After initial screening, participants in both groups will complete a baseline survey asking about demographics and health status. iMatter2 program participants will also be asked about a personal health goal they’d like to achieve as part of the program, and opt-in to receive text messages from two phone numbers, one for the PROs and the second for communication with the chatbot. iMatter2 program participants are then asked to respond to the PRO text messages throughout the following 12 months, interact with the chatbot to their comfort level, and view their health dashboard. All participants in both groups will be asked to send the results in from their home A1c results using the free A1c test kits provided at baseline and 12 months after baseline. iMatter2 participants will also be asked to send in their home A1c results at 3 and 6 months after baseline.

iMatter2 and Usual Care Groups

Participants enrolled in the iMatter2 group will receive and respond to daily text messages about their diabetes management for 12 months. They will also receive motivational messages to let them know how well they are doing in the program. Every two weeks, participants will also get an update on their health dashboard. They will be asked to submit their home A1c value at baseline, 3, 6, and 12 months. Participants who are placed in the UC group will continue with their standard treatment for their type 2 diabetes via their primary care provider, while also submitting their home A1c value at baseline and at 12 months from the free home self-test kit sent by research staff.

Training Information and Resources for iMatter2 Participants

People who participate in the mobile health study iMatter2 receive text messages asking for health information related to their diabetes management periodically for 12 months. They will also have access to an AI-powered chatbot, which will be available to answer any diabetes-related questions via text message; this chatbot will also provide motivational and educational content to help support participants’ self-management of their diabetes. To help track their progress over time, iMatter2 participants will have access to a MyChart login–accessible health dashboard that their providers will also have access to. From this page, participants can access frequently asked questions as well as all the educational resources available from their dashboards here.

If you are a participant and have any questions, please email us at Connected2Care@NYULangone.org.