Technology-Supported Integrated Care Innovations to Support Diabetes and Mental Health Care: Scoping Review

Abstract

Background For individuals living with diabetes and its psychosocial comorbidities (eg, depression, anxiety, and distress), there remains limited access to interprofessional, integrated care that includes mental health support, education, and follow-up. Health technology, broadly defined as the application of organized knowledge or skill as software, devices, and systems to solve health problems and improve quality of life, is emerging as a means of addressing these gaps. There is thus a need to understand how such technologies are being used to support, educate, and help individuals living with co-occurring diabetes and mental health distress or disorder. Objective The purpose of this scoping review was to (1) describe the literature on technology-enabled integrated interventions for diabetes and mental health; (2) apply frameworks from the Mental Health Commission of Canada and World Health Organization to elucidate the components, type, processes, and users of technology-enabled integrated interventions for diabetes and mental health; and (3) map the level of integration of interventions for diabetes and mental health. Methods We searched 6 databases from inception to February 2022 for English-language, peer-reviewed studies of any design or type that used technology to actively support both diabetes and any mental health distress or disorder in succession or concurrently among people with diabetes (type 1 diabetes, type 2 diabetes, and gestational diabetes). Reviewers screened citations and extracted data including study characteristics and details about the technology and integration used. Results We included 24 studies described in 38 publications. These studies were conducted in a range of settings and sites of care including both web-based and in-person settings. Studies were mostly website-based (n=13) and used technology for wellness and prevention (n=16) and intervention and treatment (n=15). The primary users of these technologies were clients and health care providers. All the included intervention studies (n=20) used technology for clinical integration, but only 7 studies also used the technology for professional integration. Conclusions The findings of this scoping review suggest that there is a growing body of literature on integrated care for diabetes and mental health enabled by technology. However, gaps still exist with how to best equip health care professionals with the knowledge and skills to offer integrated care. Future research is needed to continue to explore the purpose, level, and breadth of technology-enabled integration to facilitate an approach to overcome or address care fragmentation for diabetes and mental health and to understand how health technology can further drive the scale-up of innovative integrated interventions.

The role of social media on psychological wellbeing from the perspectives of young people with Type 1 diabetes and their caregivers: a qualitative study

“…This has important practical implications because it affirms that social media, and in particular, online peer support, has a substantial role in diabetes education, self-care skill acquisition, and building emotional resilience. This aligns with previous research exploring self-care in this population (Malik et al, 2019;Moreira et al, 2023;Racey et al, 2023). Caregivers similarly recognized the value of social media as a tool to facilitate learning from the experiences of other young people living with type 1 diabetes.…”

“…Malik et al (2019) carried out focus groups with 13-19-year-olds living with type 1 diabetes and participants generally felt that social media supported personalized, accessible diabetes selfcare and facilitated connection with peers, thus increasing a sense of cohesion (togetherness) and empowerment (Malik et al, 2019). There is a substantial body of evidence to suggest that social media can support diabetes self-care, and is of growing interest in the diabetes community (Ho et al, 2014;Malik et al, 2019;Moreira et al, 2023;Racey et al, 2023;Reidy et al, 2019). Nonetheless, concern has been expressed about the reputability of health information made available online and about privacy/confidentiality uncertainties, risk of information overload, and the risk of receiving information in the absence of training in how to apply it in practice (Elnaggar et al, 2020;Kong et al, 2021;Malik et al, 2019;McDarby et al, 2015;Racey et al, 2023;Reidy et al, 2019).…”

“…There is a substantial body of evidence to suggest that social media can support diabetes self-care, and is of growing interest in the diabetes community (Ho et al, 2014;Malik et al, 2019;Moreira et al, 2023;Racey et al, 2023;Reidy et al, 2019). Nonetheless, concern has been expressed about the reputability of health information made available online and about privacy/confidentiality uncertainties, risk of information overload, and the risk of receiving information in the absence of training in how to apply it in practice (Elnaggar et al, 2020;Kong et al, 2021;Malik et al, 2019;McDarby et al, 2015;Racey et al, 2023;Reidy et al, 2019).…”

Technology-Enabled Collaborative Care for Type-2 Diabetes and Mental Health (TECC-D): Findings From a Mixed Methods Feasibility Trial of a Responsive Co-Designed Virtual Health Coaching Intervention

“…Globally, there are a growing number of integrated diabetes and mental health programs supported by technology [38]. Like the TECC-D model, many of these models focus on promoting wellness, preventing complications, and enhancing self-management and treatment for those living with diabetes and co-occurring mental health challenges [38]. However, unique to the TECC-D model is the embrace of existing and widelyavailable technology to enable this connection and care.…”

Prevalence and Associated Factors of Psychological Distress Among Diabetic Patients at Thyolo District Hospital in Malawi: A Hospital-Based Cross-Sectional Study [Letter]

“… 4 Behavioral health providers, in particular, can play a pivotal role in addressing mental health concerns unique to diabetes, thereby optimizing health outcomes and enhancing overall quality of life. 5 …”