Development and Usability of REACH: A Tailored Theory-Based Text Messaging Intervention for Disadvantaged Adults With Type 2 Diabetes

Nelson, Lyndsay A.; Mayberry, Lindsay S.; Wallston, Kenneth A.; Kripalani, Sunil; Bergner, Erin M.; Osborn, Chandra Y.

doi:10.2196/humanfactors.6029

Cited by 66 publications

(70 citation statements)

References 69 publications

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“…We previously conducted a thorough review of published studies describing patient-reported barriers to adherence for oral hypoglycemic medications and/or insulin among adults with type 2 diabetes [35]. Across 30 studies, we identified 68 barriers to taking medications and 7 barriers to taking insulin.…”

Section: Methodsmentioning

confidence: 99%

“…We collapsed similar barriers, resulting in 36 adherence barriers (5 of which were insulin-specific) and mapped those barriers to the IMB model’s information, motivation, and behavioral skills constructs. Using these patient-reported barriers identified in the literature, we developed a barrier assessment [35] in which each barrier is written as a first-person statement (e.g., “Seeing no immediate benefit from taking medication” was modified to read “I’m disappointed when my medicine doesn’t improve my diabetes right away”). We enrolled adults with type 2 diabetes in a randomized controlled trial (RCT) [36] to evaluate a text messaging intervention which uses participants’ barriers identified with this assessment to tailor text message content.…”

Section: Methodsmentioning

confidence: 99%

“…We used a two-step, interactive procedure to boost reporting of barriers to diabetes medication adherence for purposes of tailoring the intervention to participants’ barriers [35]. First, participants were asked to complete a card-sorting task.…”

Section: Methodsmentioning

confidence: 99%

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Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model

Nelson

Wallston

LeStourgeon

et al. 2018

Diabetes Research and Clinical Practice

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Aims: Medication nonadherence is a prevalent and costly problem among patients with type 2 diabetes. Applications of theory can inform and improve adherence promotion interventions. We used a new assessment based on the Information-Motivation-Behavioral skills (IMB) model of adherence to assess patient-reported barriers and test the theoretical model. Methods: Participants (N = 237) completed a card sorting task to identify barriers to adherence, a survey, and a hemoglobin A1c (HbA1c) test. We identified the most commonly reported adherence barriers and examined associations between patient characteristics and barriers mapped onto each of the IMB constructs. We used structural equation modeling to test the IMB model and determine if barriers as reported on this measure predict patients’ self-reported diabetes medication adherence and, in turn, HbA1c levels. Results: The most frequently reported barriers were forgetting doses, thinking brand name medicine works better than generic medicine, not seeing immediate benefit, and feeling burned out with taking diabetes medicine. Younger age and lower health literacy were associated with higher barrier scores for all IMB model constructs. Information and social motivation barriers affected adherence via behavioral skills barriers (indirect effects −0.19, CI [−0.33, −0.09] and −0.24, CI [−0.37, −0.14], respectively). The IMB barrier constructs explained 44% of the variance in diabetes medication adherence which, in turn, was significantly associated with and explained 8% of the variance in HbA1c (both p<.001). Conclusions: Results suggest this assessment task can identify patient-specific barriers to diabetes medication adherence. Interventions targeting patient-specific barriers using this assessment could improve adherence and HbA1c.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model

Nelson

Wallston

LeStourgeon

et al. 2018

Diabetes Research and Clinical Practice

Self Cite

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“…There is a significant body of literature on text messaging as a means of, for instance, supporting people with chronic illness; [46][47][48] facilitating adherence and/or attendance; [49][50][51][52] conveying results of tests; 53 or sending health promotion messages. [54][55][56][57] Systematic reviews have indicated that text messaging can be effective in facilitating short-term behaviour and medication adherence in particular.…”

Section: Text Messaging and E-mailmentioning

confidence: 99%

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Shaw

Wherton

Vijayaraghavan

et al. 2018

Health Serv Deliv Res

148

186

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 13/59/26. The contractual start date was in March 2015. The final report began editorial review in July 2017 and was accepted for publication in November 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Depar...

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“…However, they only express opinions on potential use based on trying out the app with the assistance of a researcher. Such evaluations of technology prototypes through interviews are an important step in a user-centred design process and commonly reported in the health informatics literature, including in the area of diabetes (e.g., [23,[39][40][41][42]). The critical next step is a deployment study where patients and their carers can use and evaluate the app over several weeks or months in their daily lives to evaluate the actual impact on self-care.…”

Section: Limitationsmentioning

confidence: 99%

Promoting Self-Care of Diabetic Foot Ulcers through a Mobile Application: A User-Centred Design and Evaluation (Preprint)

Ploderer¹,

Brown²,

Seng³

et al. 2018

Preprint

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Background: Without effective self-care, people with diabetic foot ulcers (DFUs) are at risk of prolonged healing times, hospitalization, amputation, and reduced quality of life. Despite these consequences, adherence to DFU self-care remains low. New strategies are needed to engage people in the self-care of their DFUs. Objective: We aimed to evaluate the usability and usefulness of a new mobile application to engage people with DFUs in self-care. Methods: We developed a new mobile application, "MyFootCare", to engage patients with DFU through goal-setting, progress monitoring, and reminders in self-care. Key features included novel visual analytics that automatically extracts and monitors DFU size information from mobile phone photos of the foot. A functional prototype of MyFootCare was created and evaluated through a user-centred design process with 11 participants with DFUs. Data were collected through semi-structured interviews discussing existing self-care practices and observations of MyFootCare with participants. Data were analysed qualitatively through thematic analysis. Results: Key themes were: (1) Participants already used mobile phone photos to monitor their DFU progress, but (2) had limited experience with using smartphone applications. (3) Participants desired the objective DFU size data provided by the tracking feature of MyFootCare to monitor their DFU progress. (4) Participants were ambivalent about the MyFootCare goal setting and diary features, commenting that these features were useful but also that it was unlikely that they would use them. (5) Participants desired to share their MyFootCare data with their clinicians to demonstrate engagement in self-care and to reflect on their progress. Conclusions: MyFootCare shows promising features to engage people in DFU self-care. Most notably, ulcer size data is useful to monitor progress and engage people. However, more work is needed to improve the usability and accuracy of MyFootCare, i.e., by refining the process of taking and analysing DFU photos and removing unnecessary features. These findings open the door for further work to develop a system that is easy to use and functions in everyday life conditions, and to trial it with people with DFUs and their carers.

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Development and Usability of REACH: A Tailored Theory-Based Text Messaging Intervention for Disadvantaged Adults With Type 2 Diabetes

Cited by 66 publications

References 69 publications

Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model

Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Promoting Self-Care of Diabetic Foot Ulcers through a Mobile Application: A User-Centred Design and Evaluation (Preprint)

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