Effect of Using Mobile Phone Communication on Morbidity and Health Seeking Behavior of Type 2 Diabetes Mellitus Patients at Kitui County Referral Hospital, Kenya

Background The worldwide prevalence of type 2 diabetes (T2D) has increased in the past decade, and it is projected to increase by 126% by 2045 in Africa. At the same time, mobile phone use has increased in Africa, providing a potential for innovative mobile health interventions to support diabetes care. Objective This study aimed to apply the Behavior Change Wheel (BCW) framework to develop text messages to influence food literacy in adults with T2D in urban Kenya. Methods The 8 steps of the BCW framework guided the development of text messages: (1) Define the problem in behavioral terms; (2) select target behaviors; (3) specify the target behaviors based on who needs to perform the behaviors, what needs to change, and when, where, how often, and with whom; (4) identify what needs to change; (5) identify intervention functions; (6) select policy categories; (7) select behavior change techniques (BCTs); and (8) select the mode of delivery. Recent exploratory studies in Kenya and other low- and middle-income countries provided information that was used to contextualize the intervention. Results In step 1, the behavioral problem was defined as unhealthy dietary patterns among adults with T2D. In step 2, based on a qualitative study in the target population, the target behavior was selected to be evaluation of reliable sources of information, and selection and preparation of healthy food. In step 3, unhealthy dietary patterns were selected. In step 4, 10 domains of the Theoretical Domains Framework were identified, and in step 5, 5 intervention functions were linked to the domains and unhealthy dietary patterns were specified. In step 6, communication and regulations were identified as policy categories, while in step 7, 9 BCTs were selected from the Behavior Change Technique Taxonomy version 1. In step 8, the most suitable mode of delivery was determined to be mobile text messages. A total of 36 mobile text messages were developed based on the 9 BCTs. Conclusions This study shows the step-by-step application of the BCW framework to develop mobile text messages to influence food literacy in adults with T2D. International Registered Report Identifier (IRRID) RR1-10.2196/48271

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Designing Mobile Phone Text Messages Using the Behavior Change Wheel Framework to Influence Food Literacy in Adults With Type 2 Diabetes in Kenya: Protocol for a Systematic Development Study (Preprint)

Mokaya¹,

Kyallo²,

Yiga³

et al. 2023

Preprint

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BACKGROUND The global prevalence of type 2 diabetes has risen alarmingly in the past decade in sub-Saharan Africa. At the same time, mobile phone use has increased in Africa, providing a potential for innovative mobile health (mHealth) interventions to support diabetes care. OBJECTIVE This study aimed to apply the Behaviour Change Wheel (BCW) to design and develop a mHealth intervention to optimize glycaemic control in adults with type 2 diabetes in urban Kenya METHODS The three stages of the BCW that include understanding the behaviour identifying the intervention options and identifying content and implementations options guided the development of this mHealth intervention. Recent preparatory studies from low- and middle-income countries (LMICs) provided information that was used to contextualize the three stages of intervention development. RESULTS Stage 1 revealed unhealthy eating patterns, characterized by low intake of fruits and vegetables and larger portion sizes of carbohydrates, as the key behaviour problem. In stage 2, target options to optimize glycaemic control were identified and related to food literacy components, including nutrition information, food selection, meal preparation and eating. In stage 3, text messages were selected as the delivery mode. A total of 36 mobile text messages were developed based on nine behaviour change techniques. CONCLUSIONS We developed a mHealth guided by the step-by-step BCW framework while using evidence from the target population. We, therefore, created contextualized intervention components and applied behaviour change techniques that were used to design mobile text messages to optimize glycaemic control for adults with type 2 diabetes in LMICs. The effectiveness of this intervention will be tested in a proof-of-concept study in the target population

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Effect of Using Mobile Phone Communication on Morbidity and Health Seeking Behavior of Type 2 Diabetes Mellitus Patients at Kitui County Referral Hospital, Kenya

Cited by 4 publications

References 42 publications

Effect of using mobile phone communication on dietary management of Type 2 Diabetes Mellitus patients in Kenya

Effect of using mobile phone communication on dietary management of Type 2 Diabetes Mellitus patients in Kenya

Designing Mobile Phone Text Messages Using the Behavior Change Wheel Framework to Influence Food Literacy in Adults With Type 2 Diabetes in Kenya: Protocol for a Systematic Development Study

Designing Mobile Phone Text Messages Using the Behavior Change Wheel Framework to Influence Food Literacy in Adults With Type 2 Diabetes in Kenya: Protocol for a Systematic Development Study (Preprint)

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