Impact of digital health interventions for adolescents with type 1 diabetes mellitus on health literacy: a systematic review

Abstract

Background Evidence shows that living with diabetes mellitus type 1 (T1DM) in adolescent age is particularly challenging and difficult to manage. A high level of health literacy is important to prevent and avoid debilitating complications. Despite the increasing prevalence and incidence of T1DM by adolescent and the large use of digital health interventions, little is known about the association between this use and health literacy. This systematic review provides an overview on the impact of digital health interventions for adolescents with type 1 diabetes on health literacy and derive recommendations for further research. Methods Electronic searches were performed in five databases in Medline (Medline, PubMed + via PubMed), The Cochrane Library, EMBASE (via Ovid), Web of Science and PsycINFO from 2011 to 2021. In addition, grey literature searches were conducted in Google Scholar, OAlster and Trip. Relevant studies that have been missed by electronic and hand-searching strategies were searched in the reference lists of all included studies. The review followed PRISMA guidelines. Two researchers independently screened abstracts for initial eligibility and applied the inclusion and exclusion criteria to the relevant full-text articles. Quality was assessed using the tools RoB2 Cochrane, ROBINS I, NOS (Newcastle–Ottawa Scale), CASP (Critical Appraisal Skills Programme) for primary studies and Amstar-2 for secondary studies. Results Out of 981 studies, 22 were included in the final review. Most primary studies included in this review were judged as moderate overall risk of bias or with some concerns and most of the secondary studies as critically low quality reviews. Our findings suggest that the interplay of health care providers (HCP) and patients through social media helps the management of the disease. This corroborates Bröder et al.’ (2017) dimension of ‘communication and interactions’ in their concept of health literacy. Conclusions For adolescents with T1DM, social media may be a specific and beneficial intervention for an improved communication and interaction with their HCP. Further research should investigate what specific form of social media suits best for which adolescents. Trial registration The study protocol was registered on the 15th of November 2021 on Prospero (reg. NR: CRD42021282199).

Digital interventions for adolescents with type 1 diabetes to promote health literacy? A qualitative study on physicians’ perspective in Germany

“…This study also contributes an analysis of the challenges associated with the utilisation of digital interventions to promote HL, as perceived by physicians. social platforms and patient portals, 4 could promote health literacy (HL), 5 which is crucial to prevent complications, increase quality of life and significantly impact clinical outcomes. [6][7][8][9] The authors refer to the study of Bröder et al, 10 who identify 14 dimensions of HL that have been developed for children and adolescents, clustered in three core categories, namely (a) cognitive attributes, which correspond to the ability to think, learn and process information, (b) behavioural or operational attribute and (c) affective and conative attribute.…”