Acceptability and Feasibility of a Diabetes Education Unidirectional Text Message Intervention for the Hmong Community

The Hmong community experiences disparities in diabetes outcomes. Diabetes education materials need to be tailored to the intended audience’s culture, language, and traditions to be effective. In other communities, text messaging is an acceptable and effective way to deliver diabetes education; it is unknown whether this strategy would yield similar outcomes in the Hmong community. A unidirectional text message program was created to deliver a previously tested, tailored diabetes curriculum. Twenty-five self-identified Hmong adults with diabetes were recruited. Participation required a phone with text messaging (short message service) capability and consenting to receive two messages per week for four weeks. Messages were sent in English with a hyperlink to listen to the message spoken in Hmong, to reach those with both English and Hmong language preferences. After completing this phase of the curriculum, participants completed an experiential survey. Most reported reading or listening to the messages at least “most times”, found the information relevant, shared it with others, and did not experience stress from the messages. Despite testing and training, a third of participants experienced access issues. The learnings in this area reveal that these were largely due to programming issues in the chosen software, and are therefore avoidable for future interventions. However, some of the reported issues were related to technology literacy. These findings indicate signal feasibility and acceptability for a multilingual, unidirectional diabetes education text messaging intervention. Future work should further assess the accessibility and acceptability and evaluate its impact on diabetes outcomes.