Research Summary
Analyzed using Evidence Intelligence™

Text Messaging Improves Diabetes Self-Care More Than Educational Materials Alone

Last updated July 8, 2026

Key finding

Average reduction in HbA1c was 0.76% ± 0.12% (p ≤ 0.0001)

The MODEL Study evaluated patient-centered behavioral interventions for diabetes self-care, finding significant improvements in healthy eating days and HbA1c levels.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Risk of bias

High Risk

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

The MODEL Study evaluated patient-centered behavioral interventions for diabetes self-care, finding significant improvements in healthy eating days and HbA1c levels.

Clinical relevance

These findings highlight the importance of patient-centered behavioral interventions in managing diabetes. By improving dietary habits and lowering HbA1c levels, these strategies can lead to better health outcomes for individuals with diabetes, potentially reducing the risk of complications associated with the disease.

Keep in mind

Effectiveness of interventions remains unclear due to lack of detailed statistical analysis. Potential biases in self-reported dietary habits. Limited generalizability to broader diabetes populations.

Published in

Journal Reference

Publication details and source links for this paper.

James EB, Satya S, Justin G, et al. The MODEL Study: A Pragmatic Randomized Controlled Trial of Patient-Centered Behavioral Interventions for Diabetes Self-Care. Journal of General Internal Medicine. 2025;41(6):1573-1583. doi:10.1007/s11606-025-09882-z

Main Effects

EM participants increased healthy eating days by 0.67 ± 0.19 day/week.

HC+EM participants increased healthy eating days by 0.99 ± 0.15 day/week.

TM+EM participants increased healthy eating days by 1.36 ± 0.15 day/week.

Average reduction in HbA1c was 0.76% ± 0.12%.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Remote multiprofessional educational program, SMS text messaging behavioral intervention for health promotion, Telephone-based pharmacist behavioral intervention and HbA1c, Increase in Healthy Eating Days per Week.

Primary intervention

Remote multiprofessional educational program

Primary outcomes

  • HbA1c
  • Increase in Healthy Eating Days per Week

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

6
Evidence pairs
6
Relationships
3
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 69

3

Related topics

6

Evidence pairs

893

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 6 evidence relationships
  • Includes primary outcome data
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and HbA1c

Related evidence

Evidence topic

HbA1c Reduction

Save evidence

Evidence topic

Diabetes Self-Management Education and Support

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

HbA1c

Remote multiprofessional educational program → HbA1c

Remote multiprofessional educational program → HbA1c

Evidence Intelligence™
EvidenceScore™
83
Strong
ImpactScore™
83
Positive
ConsistencyScore™
83
consistent
Supporting studies: Based on 6 studies
Add to Evidence Tracker

Increase in Healthy Eating Days per Week

Remote multiprofessional educational program → Increase in Healthy Eating Days per Week

Remote multiprofessional educational program → Increase in Healthy Eating Days per Week

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

HbA1c

SMS text messaging behavioral intervention for health promotion → HbA1c

SMS text messaging behavioral intervention for health promotion → HbA1c

Evidence Intelligence™
EvidenceScore™
83
Strong
ImpactScore™
67
Slightly Positive
ConsistencyScore™
80
consistent
Supporting studies: Based on 6 studies
Add to Evidence Tracker

Increase in Healthy Eating Days per Week

SMS text messaging behavioral intervention for health promotion → Increase in Healthy Eating Days per Week

SMS text messaging behavioral intervention for health promotion → Increase in Healthy Eating Days per Week

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

HbA1c

Telephone-based pharmacist behavioral intervention → HbA1c

Telephone-based pharmacist behavioral intervention → HbA1c

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Increase in Healthy Eating Days per Week

Telephone-based pharmacist behavioral intervention → Increase in Healthy Eating Days per Week

Telephone-based pharmacist behavioral intervention → Increase in Healthy Eating Days per Week

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Evidence Library

Build your evidence library

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evidence suggest

Evidence Suggest

  • EM led to a 0.67 day/week increase in healthy eating.
  • HC+EM resulted in a 0.99 day/week increase in healthy eating.
  • TM+EM showed a 1.36 day/week increase in healthy eating.
who this applies

Who this applies to

  • Adults with type 2 diabetes.
  • Patients seeking to improve their diabetes self-care.
keep in mind

Keep in Mind

  • Results may not apply to all demographics of diabetes patients.
  • Further research is needed to confirm long-term effects.
  • Self-reported data may introduce bias in dietary assessments.
between the lines

Between the Lines

  • Effectiveness of interventions remains unclear due to lack of detailed statistical analysis.
  • Potential biases in self-reported dietary habits.
  • Limited generalizability to broader diabetes populations.

Evidence Library

Build your evidence library

Save research, organize studies, and quickly find important evidence again.

Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and HbA1c, Diabetes Self-Management Education and Support (DSMES) Programs and HbA1c.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Do Diabetes Self-Management Education and Support (DSMES) Programs lower HbA1c?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs may lower HbA1c.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    HbA1c

    EvidenceScore™ Strong | EvidenceScore™ 83.0 | weak positive | ConsistencyScore™ Consistent | 1 study

Why this answer: This answer is based on 44 supporting studies with generally consistent results and a positive effect signal.

44 supporting studies

What evidence is available on Remote multiprofessional educational program and increase in healthy eating days per week?

Emerging Evidence

Remote multiprofessional educational program appears to improve increase in healthy eating days per week.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Increase in Healthy Eating Days per Week

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

What evidence is available on SMS text messaging behavioral intervention for health promotion and increase in healthy eating days per week?

Emerging Evidence

SMS text messaging behavioral intervention for health promotion appears to improve increase in healthy eating days per week.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Increase in Healthy Eating Days per Week

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

What evidence is available on Telephone-based pharmacist behavioral intervention and increase in healthy eating days per week?

Emerging Evidence

Telephone-based pharmacist behavioral intervention appears to improve increase in healthy eating days per week.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Increase in Healthy Eating Days per Week

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
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