A Pilot Randomized Trial of Text-Messaging for Symptom Awareness and Diabetes Knowledge in Adolescents With Type 1 Diabetes

Han, Yi; Faulkner, Melissa Spezia; Fritz, Heather; Fadoju, Doris; Muir, Andrew; Abowd, Gregory D.; Head, Lauren M.; Arriaga, Rosa I.

doi:10.1016/j.pedn.2015.02.002

Cited by 31 publications

(53 citation statements)

References 31 publications

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“…A total of ten RCTs [28–37] and three non-RCTs [38–40] measured HbA1c as a clinical indicator of diabetes self-management. Five of the RCTs demonstrated low risk [28, 33–35, 37] three RCTs had unknown risk [29, 30, 36], one RCT had moderate risk [32] and one had moderate-high risk of bias [31]. Of the non-RCTs, two demonstrated a moderate risk of bias [38, 40] and one demonstrated a high risk of bias [39].…”

Section: Resultsmentioning

confidence: 99%

Impact of technology-based interventions for children and young people with type 1 diabetes on key diabetes self-management behaviours and prerequisites: a systematic review

et al. 2019

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BackgroundThe role of technology in the self-management of type 1 diabetes mellitus (T1DM) among children and young people is not well understood. Interventions should aim to improve key diabetes self-management behaviours (self-management of blood glucose, insulin administration, physical activity and dietary behaviours) and prerequisites (psychological outcomes and HbA1c) highlighted in the UK guidelines of the National Institute for Health and Care Excellence (NICE) for management of T1DM. The purpose was to identify evidence to assess the effectiveness of technological tools in promoting aspects of these guidelines amongst children and young people.MethodsA systematic review of English language articles was conducted using the following databases: Web of Science, PubMed, Scopus, NUSearch, SAGE Journals, SpringerLink, Google Scholar, Science Direct, Sport Discus, Embase, Psychinfo and Cochrane Trials. Search terms included paediatric, type one diabetes, technology, intervention and various synonyms. Included studies examined interventions which supplemented usual care with a health care strategy primarily delivered through a technology-based medium (e.g. mobile phone, website, activity monitor) with the aim of engaging children and young people with T1DM directly in their diabetes healthcare. Studies did not need to include a comparator condition and could be randomised, non-randomised or cohort studies but not single-case studies.ResultsOf 30 included studies (21 RCTs), the majority measured self-monitoring of blood glucose monitoring (SMBG) frequency, clinical indicators of diabetes self-management (e.g. HbA1c) and/or psychological or cognitive outcomes. The most positive findings were associated with technology-based health interventions targeting SMBG as a behavioural outcome, with some benefits found for clinical and/or psychological diabetes self-management outcomes. Technological interventions were well accepted by children and young people. For the majority of included outcomes, clinical relevance was deemed to be little or none.ConclusionsMore research is required to assess which elements of interventions are most likely to produce beneficial behavioural outcomes. To produce clinically relevant outcomes, interventions may need to be delivered for at least 1 year and should consider targeting individuals with poorly managed diabetes. It is not possible to determine the impact of technology-based interventions on insulin administration, dietary habits and/or physical activity behaviour due to lack of evidence.

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Section: Resultsmentioning

confidence: 99%

Impact of technology-based interventions for children and young people with type 1 diabetes on key diabetes self-management behaviours and prerequisites: a systematic review

et al. 2019

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“…The glycemic control is even better if diabetes education is done by a combination of SMS and internet methods, i.e., 86% effect in comparison with 44% that is achieved by SMS alone [93]. Positive results of e-mail and SMS education can also be seen in improved quality of life [94].…”

Section: Educationmentioning

confidence: 99%

Empowering Diabetes Patient with Mobile Health Technologies

Krošel¹,

Švegl²,

Vidmar³

et al. 2016

Mobile Health Technologies - Theories and Applications

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Chronic diseases, especially diabetes mellitus, are huge public health burden. Therefore, new health care models for sharing the responsibility for care among health care providers and patients themselves are needed. The concept of empowerment promotes patient's active involvement and control over their own health. It can be achieved through education, self-management, and shared decision making. "ll these aspects can be covered by mobile health technologies, the so-called mHealth. This term comprises mobile phones, patient monitoring devices, tablets, personal digital assistants, other wireless devices, and numerous apps. Many challenges of diabetics can be addressed by mHealth, including glycemic control, nutrition control, physical activity, high blood pressure, medication adherence, obesity, education, diabetic retinopathy screening, diabetic foot screening, and psychosocial care. However, mHealth plays only minor role in diabetes management, despite numerous apps on the market. Namely, these apps have many shortcomings and the majority of them does not include important functions. Moreover, these apps lack the perceived additional benefit by the user and the ease of use, important factors for acceptance of mHealth. Studies of diabetes apps regarding usability and accessibility have shown moderate results. "eside improvements of apps usability, the future of diabetes mHealth lies probably in personalized education and self-management with the help of decision support systems. "t the same time, work on artificial pancreas is in progress and smartphone could be used as user interface.

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“…While mHealth interventions have been efficacious for a variety of indications [ 9 , 10 , 13 ], a downside to these methods may be low levels of engagement. Studies have provided participants with cell phones or prepaid phone cards to facilitate their participation [ 12 , 15 ]. Others have reported that technical problems led to a loss of data and affected the participants’ levels of motivation to continue in the study [ 15 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have provided participants with cell phones or prepaid phone cards to facilitate their participation [ 12 , 15 ]. Others have reported that technical problems led to a loss of data and affected the participants’ levels of motivation to continue in the study [ 15 - 18 ]. Past studies have assessed feasibility as participant satisfaction and rates of participant retention [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Others have reported that technical problems led to a loss of data and affected the participants’ levels of motivation to continue in the study [ 15 - 18 ]. Past studies have assessed feasibility as participant satisfaction and rates of participant retention [ 15 , 16 ]. In determining the efficacy of mHealth interventions, outcome measures are varied and include biomarker reductions, self-reported efficacy, and changes in disease or condition knowledge [ 11 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study

et al. 2020

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Background Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. Objective In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. Methods For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. Results Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (P=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. Conclusions In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.

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A Pilot Randomized Trial of Text-Messaging for Symptom Awareness and Diabetes Knowledge in Adolescents With Type 1 Diabetes

Cited by 31 publications

References 31 publications

Impact of technology-based interventions for children and young people with type 1 diabetes on key diabetes self-management behaviours and prerequisites: a systematic review

Impact of technology-based interventions for children and young people with type 1 diabetes on key diabetes self-management behaviours and prerequisites: a systematic review

Empowering Diabetes Patient with Mobile Health Technologies

A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study

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