Reducing Diabetes Risk With Text Messages

Art Gillespie
Jan 7, 2020
Reading Time 3 minutes

I recently discovered a fascinating long-range study from 2009-2012 into the effects of microlearning on behavioral change. You can find the original paper here. In this extraordinary study, the researchers found that participants at risk for type 2 Diabetes were significantly less likely to develop the disease when they received regular text messages in addition to a more traditional one-time health training compared to those that only received the training.

How significant? 27% of the group that only received the traditional instruction went on to develop type 2 diabetes, while only 18% of the group that received the text messages did–a 33% improvement. What's even more remarkable is that the researchers found that the text messages were nearly as effective as routine personal contact.

This is a compelling example of microlearning's power and simplicity. Between two and four times each week, on a schedule chosen by the subjects, the researchers sent short, simple messages like “All you need is 30 minutes of moderate physical activity on most days of the week.", and “Are you stressed out! Stress increases blood sugar. Go for a walk and relax.” It almost seems counterintuitive that such a simple intervention could lead to statistically significant results on a hard behavioral problem like diet and exercise.

screenshot of text message: Go for a walk and relax

Fig 1. An example text message from the study

The improvements didn't just come at the end of the study, either. Researchers recorded a significant difference between the text message group and the control group at just six months:

chart of research results

Fig 2. Probability of remaining free of type 2 diabetes.

This kind of traditional training + microlearning is a potent combination. Imagine following up a sales training with six months of periodic, adaptive Slack messages reinforcing new product features and the company's sales message. Or supplementing your programming workshop with a series of adaptive, spaced questions designed to reinforce the workshop's skill pushed automatically to participants for months after the workshop ends. Or using messages and questions to onboard new employees.

This approach is infinitely better than a classroom or webinar training with a pdf “leave-behind”, because they are pushed to the participant where they are and keep the material front-of-mind. Simply reminding them of information they've been exposed is far more effective than expecting them to proactively return to the material and refresh. And if you supplement those reminders with multiple-choice questions and flash cards, the impact is even greater thanks to retrieval effects. If you adaptively schedule messages and questions based on the participant's responses to earlier messages, the impact is greater still.

One excellent example of this approach is Crescendo Moments which provides curated learning paths around culture, diversity, and inclusion for employes inside Slack. Instead of employees needing to remember to check the D&I section of their intranet, or refer to a D&I handbook, information is customized and pushed to them in the flow of work

Animated gif of crescendo slack app on mobile

Fig 3. Crescendo Moments in Slack.

I expect to see many more examples of this type of supplemental training in sales, technical, culture, onboarding, and beyond in the years to come. With the continuing growth realtime communications platforms like Slack, Microsoft Teams, and Workplace by Facebook and the outsized impact of this kind of adaptive, push-based learning evidenced by the India diabetes study, one can't help but think that all training will have a microlearning component in the years to come.


At trainify, we're building a platform to make make realtime microlearning accessible to everyone. If you're interested in delivering adaptive microlearning using Slack, Microsoft Teams, or Workplace by Facebook, we'd love to talk!


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