The Impact of a Medication Refill Adherence Text Messaging Solution on Black and Latino Adults: Secondary Analysis of Randomized Controlled Trial (Preprint)
Year: 2025
Type: preprint
Abstract: BACKGROUND Cardiovascular disease is a leading cause of death among adults, particularly for minority groups, such as African American or Black (hereafter referred to as Black) and Hispanic or Latino (hereafter referred to as Latino) adults. Mobile health solutions, specifically text messaging, are a promising method for delivering self-management interventions to adults who have cardiovascular disease. The Nudge study was a randomized controlled trial (RCT) text message intervention designed to improve medication refill adherence. This secondary analysis uses Nudge study to understand whether Black and Latino adults respond differently than White adults to one of the Nudge’s theory-based study arm. OBJECTIVE The study explored whether text message refill reminders could improve self-reported responses to refilling medication among Black and Latino adults with one or more cardiovascular diseases compared to White adults. METHODS This study was a secondary analysis from the Nudge study to examine the effectiveness of one of the four intervention study arms (optimized study arm) designed with theory-based text messages. This study analyzed self-reported response times between Black, Latino, and White adults and self-reported responses between Spanish and English speakers. The dataset observed adult over 18 years old from Denver Health, a federally qualified health center, who were assigned to the optimized study arm between November 2019 and May 2020. Descriptive statistics were used to illustrate patient characteristics including: age, gender, race, ethnicity, and language preference for text message refill reminders. Linear regression models were used to estimate predictors, age and language preference, influencing refill adherence. Statistical analysis was performed in R studio. RESULTS A total of 410 adults with CVD condition(s) from the optimized study arm at Denver Health received refill text message reminders. Of those 26.3% (108/410) responded by text message to self-report refilling their prescription. The estimated median response time(s) for 19% of White adults who responded was 2 hours, compared to the 15% of Black adults who responded within 30 hours, 62% of Latino adults who responded within 50 hours, and 4% of adults who identified as Other who responded within 60 hours. The estimated median response time for 62% of Spanish-speaking adults was the same for English-speaking adults, both at 50 hours. Linear regression was used however no association was found between response time and race (White; p =0.924). Another linear regression was used however no association was found between response time and language preference (Spanish; p=0.895). CONCLUSIONS This secondary analysis suggests Black and Latino adults with cardiovascular disease may take additional time to respond compared to White adults. The estimated self-reported response time between Spanish-speaking and English-speaking adults was the same. Although not significantly different, it suggests the importance of exploring other barriers that may impact response times among Black and Latino adults.
Authors: Starlynne Gornail, Alexander Kaizer, Gary Foster, Susan Moore, Michael Ho, Sheana Bull
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4410034891