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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
    <article-id pub-id-type="publisher-id">v2i1e32</article-id>
    <article-id pub-id-type="pmid"/>
    <article-id pub-id-type="doi">10.2196/iproc.6163</article-id>
    <article-categories>
      <subj-group subj-group-type="heading">
        <subject>Poster</subject>
      </subj-group>
      <subj-group subj-group-type="article-type">
        <subject>Poster</subject>
      </subj-group>
    </article-categories>
    <title-group>
      <article-title>Targeted Diabetes Education Text Messaging Program Increases Requests for Certified Diabetes Educator Coaching and Improves Blood Glucose Trends</article-title>
    </title-group>
    <contrib-group>
      <contrib contrib-type="editor">
        <name>
          <surname>Hale</surname>
          <given-names>Timothy</given-names>
        </name>
      </contrib>
    </contrib-group>
<contrib-group>
<contrib contrib-type="reviewer">
<name>
<surname>CHS Scientific Program Committee</surname>
</name>
</contrib>
</contrib-group>
    <contrib-group>
      <contrib contrib-type="author" id="contrib1">
        <name name-style="western">
          <surname>Pulizzi</surname>
          <given-names>Jodi</given-names>
        </name>
        <degrees>RN, CDE</degrees>
        <xref rid="aff1" ref-type="aff">1</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib2" corresp="yes">
      <name name-style="western">
        <surname>Bollyky</surname>
        <given-names>Jennifer</given-names>
      </name>
      <degrees>MD</degrees>
      <xref rid="aff1" ref-type="aff">1</xref>
      <address>
        <institution>Livongo Health</institution>
        <addr-line>150 Evelyn Ave #150</addr-line>
        <addr-line>Mountain View, CA, 94041</addr-line>
        <country>United States</country>
        <phone>1 206 403 8450</phone>
        <fax>1 206 403 8450</fax>
        <email>jbollyky@livongo.com</email>
      </address>  
      <ext-link ext-link-type="orcid">http://orcid.org/0000-0002-2037-2843</ext-link></contrib>
      <contrib contrib-type="author" id="contrib3">
        <name name-style="western">
          <surname>Toles</surname>
          <given-names>Anastasia</given-names>
        </name>
        <degrees>MD, MPH</degrees>
        <xref rid="aff1" ref-type="aff">1</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib4">
        <name name-style="western">
          <surname>Boulos</surname>
          <given-names>Michael</given-names>
        </name>
        <degrees>BEng</degrees>
        <xref rid="aff1" ref-type="aff">1</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib5" equal-contrib="yes">
        <name name-style="western">
          <surname>Schneider</surname>
          <given-names>Jennifer</given-names>
        </name>
        <degrees>MD, MSc</degrees>
        <xref rid="aff1" ref-type="aff">1</xref>
      </contrib>
    </contrib-group>
    <aff id="aff1">
      <sup>1</sup>
      <institution>Livongo Health</institution>
      <addr-line>Mountain View, CA</addr-line>
      <country>United States</country>
    </aff>
    <author-notes>
      <corresp>Corresponding Author: Jennifer Bollyky 
      <email>jbollyky@livongo.com</email></corresp>
    </author-notes>
    <pub-date pub-type="collection"><season>Jan-Dec</season><year>2016</year></pub-date>
    <pub-date pub-type="epub">
      <day>30</day>
      <month>12</month>
      <year>2016</year>
    </pub-date>
    <volume>2</volume>
    <issue>1</issue>
    <elocation-id>e32</elocation-id>
    <!--history from ojs - api-xml-->
    <history>
      <date date-type="received">
        <day>6</day>
        <month>6</month>
        <year>2016</year>
      </date>
      <date date-type="accepted">
        <day>2</day>
        <month>8</month>
        <year>2016</year>
      </date>
    </history>
    <!--(c) the authors - correct author names and publication date here if necessary. Date in form ', dd.mm.yyyy' after jmir.org-->
    <copyright-statement>©Jodi Pulizzi, Jennifer Bollyky, Anastasia Toles, Michael Boulos, Jennifer Schneider. Originally published in Iproceedings (http://www.iproc.org), 30.12.2016.</copyright-statement>
    <copyright-year>2016</copyright-year>
    <license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/">
      <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on http://www.iproc.org/, as well as this copyright and license information must be included.</p>
    </license>  
    <self-uri xlink:href="http://www.iproc.org/2016/1/e32/" xlink:type="simple"/>
    <abstract>
      <sec sec-type="Background">
        <title>Background</title>
        <p>Livongo Diabetes Program offers a cellularly enabled blood glucose monitoring system that measures blood glucose, captures contextual data (eg, relationship to food, exercise, illness), and stores this data in the cloud. Depending on the blood glucose value, personalized recommendations are delivered back through the glucose meter. Livongo members receive an unlimited supply of glucose test strips as well as access to a diabetes coaching team for questions, goal setting, and support for extreme glucose excursions. We have previously reported that members who establish contact with Livongo coaches experience an HbA1c reduction of 0.7% on average after 90 days with the program. We hypothesized that a targeted, text-message campaign designed to provide education about taking diabetes medications would encourage members to connect with Certified Diabetes Educator (CDE) coaches available to them by phone, email, or text.</p>
      </sec>
      <sec sec-type="Objective">
        <title>Objective</title>
        <p>To determine whether diabetes medication education offered to a targeted diabetes population via text messages will increase requests for telephonic coaching.</p>
      </sec>
      <sec sec-type="Methods">
        <title>Methods</title>
        <p>We examined a 4-week text message program offered to Livongo members with a calculated or self-reported HbA1c&#62;7% to provide education about medication adherence. A total of 20 text messages were delivered during the weekdays over one month. Weekly topics included (1) Why are medications important? (2) Tips for remembering to take medications, (3) Medication myths, and (4) Overcoming barriers to taking medications.</p>
      </sec>
      <sec sec-type="Results">
        <title>Results</title>
        <p>Out of the 2017 members offered the program, 514 (25%) opted into the program and 21 (1%) members opted out. Text messaging content triggered 38 personalized CDE coaching session requests, a rate of 7.4% of participating members, which is 85% more than the rate for members who did not participate in text message program (4%).</p>
      </sec>
      <sec sec-type="Conclusions">
        <title>Conclusions</title>
        <p>These preliminary findings suggest that engaging people with diabetes through a cellular-enabled blood glucose meter with real-time, personalized education in a targeted and personalized manner helps connect members with CDE coaches and may improve blood glucose control.</p>
      </sec>
    </abstract>
    <kwd-group>
      <kwd>diabetes</kwd>
      <kwd>mobile health</kwd>
      <kwd>blood glucose</kwd>
    </kwd-group></article-meta>
  </front>
  <body>
    <p>This poster was presented at the Connected Health Symposium 2016, October 20-21, Boston, MA, United States. The poster is displayed as an image in <xref ref-type="fig" rid="figure1">Figure 1</xref> and as a PDF in <xref ref-type="app" rid="app1">Multimedia Appendix 1</xref>.</p>
    <fig id="figure1" position="float">
      <label>Figure 1</label>
      <caption>
        <p>Poster.</p>
      </caption>
      <graphic xlink:href="iproc_v2i1e32_fig1.png" alt-version="no" mimetype="image" position="float" xlink:type="simple"/>
    </fig>
  </body>
  <back>
    <app-group>
      <app id="app1">
        <title>Multimedia Appendix 1</title>
        <p>Poster.</p>
        <media xlink:href="iproc_v2i1e32_app1.pdf" xlink:title="PDF File (Adobe PDF File), 262KB"/>
      </app>
    </app-group>
  </back>
</article>
