ArticleJMIR diabetes2021
Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis.
Article in JMIR diabetes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02953262 (Improving Diabetes Care Through Effective Personalized Patient Portal Interactions), which is not on this map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Diabetes Care Through Effective Personalized Patient Portal Interactions
Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- A scoping review of studies on secure messaging through patient portals: persistent challenges and potential solutions.npj health systems · 2026Article
- Identifying Skill and Usability Barriers to Digital Health Tool Use Among Older Adult Patients in US Safety Net Clinics: Mixed Methods Study.JMIR human factors · 2026Article
- Physicians' Experiences Using Secure Messaging for Diabetes Management: A Qualitative Study.JMIR diabetes · 2025Article
- High Users of Primary Care Secure Messaging in the Veterans Health Administration.Annals of family medicine · 2025Article
- Evaluating the Impact of Telemedicine on Diabetes Management in Rural Communities: A Systematic Review.Cureus · 2024Review
- Understanding Patients' Preferences and Experiences During an Electronic Health Record Transition.Journal of general internal medicine · 2023Article
- The Impact of Secure Messaging in the Treatment of Patients With Diabetes Within a Primary Care Setting: Protocol for a Scoping Review.JMIR research protocols · 2023Article
- Secure Messaging for Diabetes Management: Content Analysis.JMIR diabetes · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRural patients with diabetes have difficulty accessing care and are at higher risk for poor diabetes management. Sustained use of patient portal features such as secure messaging (SM) can provide accessible support for diabetes self-management.
objectiveThis study explored whether rural patients' self-management and glycemic control was associated with the use of SM.
methodsThis secondary, cross-sectional, mixed methods analysis of 448 veterans with diabetes used stratified random sampling to recruit a diverse sample from the United States (rural vs urban and good vs poor glycemic control). Administrative, clinical, survey, and interview data were used to determine patients' rurality, use of SM, diabetes self-management behaviors, and glycemic control. Moderated mediation analyses assessed these relationships.
resultsThe sample was 51% (n=229) rural and 49% (n=219) urban. Mean participant age was 66.4 years (SD 7.7 years). More frequent SM use was associated with better diabetes self-management (P=.007), which was associated with better glycemic control (P<.001). Among rural patients, SM use was indirectly associated with better glycemic control through improved diabetes self-management (95% CI 0.004-0.927). These effects were not observed among urban veterans with diabetes (95% CI -1.039 to 0.056). Rural patients were significantly more likely than urban patients to have diabetes-related content in their secure messages (P=.01).
conclusionsMore frequent SM use is associated with engaging in diabetes self-management, which, in turn, is associated with better diabetes control. Among rural patients with diabetes, SM use is indirectly associated with better diabetes control. Frequent patient-team communication through SM about diabetes-related content may help rural patients with diabetes self-management, resulting in better glycemic control.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.