Computerized Automated Reminder Diabetes System (CARDS): E-Mail and SMS Cell Phone Text Messaging Reminders to Support Diabetes Management

Abstract

Background: Cell phone text messaging, via the Short Messaging Service (SMS), offers the promise of a highly portable, well-accepted, and inexpensive modality for engaging youth and young adults in the management of their diabetes. This pilot and feasibility study compared two-way SMS cell phone messaging with e-mail reminders that were directed at encouraging blood glucose (BG) monitoring. Methods: Forty insulin-treated adolescents and young adults with diabetes were randomized to receive electronic reminders to check their BG levels via cell phone text messaging or e-mail reminders for a 3-month pilot study. Electronic messages were automatically generated, and participant replies with BG results were processed by the locally developed Computerized Automated Reminder Diabetes System (CARDS). Participants set their schedule for reminders on the secure CARDS website where they could also enter and review BG data. Results: Of the 40 participants, 22 were randomized to receive cell phone text message reminders and 18 to receive e-mail reminders; 18 in the cell phone group and 11 in the e-mail group used the system. Compared to the e-mail group, users in the cell phone group received more reminders (180.4 vs. 106.6 per user) and responded with BG results significantly more often (30.0 vs. 6.9 per user, P ϭ 0.04). During the first month cell phone users submitted twice as many BGs as e-mail users (27.2 vs. 13.8 per user); by month 3, usage waned. Conclusions: Cell phone text messaging to promote BG monitoring is a viable and acceptable option in adolescents and young adults with diabetes. However, maintaining interest levels for prolonged intervals remains a challenge.

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis

“…Understanding who likes what is the first step to better meet the needs of users, facilitating better engagement, and, ultimately, efficacy. Quantitative studies report that being younger, 12 more educated, 12 and male 13 is associated with being more engaged with a diabetes mHealth intervention. However, this research does not account for nuanced reasons for varied engagement, such as why users who have more positive opinions of an intervention choose to use it more.…”

Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review

“…For instance, the use of mobile computing and communication technologies in healthcare (mHealth) has shown promise in supporting behavior change and self-management in the community [17][18]. By taking advantage of continuous communication via wireless networks and device portability, mobile text messaging and email systems have demonstrated positive adherence outcomes for tobacco cessation [19], weight loss [20], and blood glucose monitoring in young adults with diabetes [21]. Advances in mobile computing power and wireless connectivity to peripheral devices invite new possibilities for sensing, feedback, and control toward facilitating and sustaining effective self-managed prevention practices.…”

NICH at Its Best for Diabetes at Its Worst: Texting Teens and Their Caregivers for Better Outcomes

“…15 Text messaging programs present with varying structures, which include text messages created by the research team sent at predetermined times, 9,[12][13][14] text messages based on personal T1D-related goals sent at predetermined times, 11,15 and text messages containing feedback from the medical team in response to participantgenerated texts. 10,13 One recent study 16 combined daily predetermined informational messages with weekly interactive messages related to managing the diabetes regimen.…”