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Protocol for a randomised blocked design study using telephone and text-messaging to support cardiac patients with diabetes: a cross cultural international collaborative project

Chiung-Jung Jo Wu1257*, Huei-Chuan Sung34, Anne M Chang125, John Atherton67, Karam Kostner568, Mary Courtney9 and Steven M McPhail10112

Author Affiliations

1 School of Nursing, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove QLD 4059, Australia

2 Institute of Health and Biomedical Innovation Queensland University of Technology, Victoria Park Road, Kelvin Grove QLD 4059, Australia

3 Department of Nursing, Tzu Chi College of Technology; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan

4 Taiwanese Centre for Evidence-based Health Care, Hualien, Taiwan

5 Mater Medical Research Institute, Mater Health Services, Brisbane, Australia

6 School of Medicine, University of Queensland, Herston QLD 4029, Australia

7 Department of Cardiology, Royal Brisbane and Women’s Hospital, Butterfield Street, Brisbane QLD 4029, Australia

8 Mater Health Services, Raymond Terrace, South Brisbane QLD 4101, Australia

9 School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Banyo QLD 4014, Australia

10 Centre for Functioning and Health Research, Metro South Health, Corner of Ipswich Road and Cornwall Street, Woolloongabba QLD 4102, Australia

11 School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove QLD 4059, Australia

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BMC Health Services Research 2013, 13:402  doi:10.1186/1472-6963-13-402

Published: 9 October 2013



The prevalence of type 2 diabetes is rising internationally. Patients with diabetes have a higher risk of cardiovascular events accounting for substantial premature morbidity and mortality, and health care expenditure. Given healthcare workforce limitations, there is a need to improve interventions that promote positive self-management behaviours that enable patients to manage their chronic conditions effectively, across different cultural contexts. Previous studies have evaluated the feasibility of including telephone and Short Message Service (SMS) follow up in chronic disease self-management programs, but only for single diseases or in one specific population. Therefore, the aim of this study is to evaluate the feasibility and short-term efficacy of incorporating telephone and text messaging to support the care of patients with diabetes and cardiac disease, in Australia and in Taiwan.


A randomised controlled trial design will be used to evaluate a self-management program for people with diabetes and cardiac disease that incorporates the use of simple remote-access communication technologies. A sample size of 180 participants from Australia and Taiwan will be recruited and randomised in a one-to-one ratio to receive either the intervention in addition to usual care (intervention) or usual care alone (control). The intervention will consist of in-hospital education as well as follow up utilising personal telephone calls and SMS reminders. Primary short term outcomes of interest include self-care behaviours and self-efficacy assessed at baseline and four weeks.


If the results of this investigation substantiate the feasibility and efficacy of the telephone and SMS intervention for promoting self management among patients with diabetes and cardiac disease in Australia and Taiwan, it will support the external validity of the intervention. It is anticipated that empirical data from this investigation will provide valuable information to inform future international collaborations, while providing a platform for further enhancements of the program, which has potential to benefit patients internationally.

Trial registration

ACTRN 12611001196932.

Cardiac; Diabetes; International collaboration; Protocol; Randomised controlled trials; Self-management; Telephone; Text-messaging