scholarly journals Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

2015 ◽  
Vol 23 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Lyndsay A Nelson ◽  
Shelagh A Mulvaney ◽  
Tebeb Gebretsadik ◽  
Yun-Xian Ho ◽  
Kevin B Johnson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
Health Literacy ◽  
Low Income ◽  
Mhealth Intervention ◽  
Lower Health ◽  
The Relationship ◽  
Lower Health Literacy

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Materials and Methods Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants’ baseline characteristics and the probability of engaging with texts and calls. Results On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age ( Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Conclusions Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement.

scholarly journals The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences

2019 ◽  
Vol 47 (3) ◽  
pp. 474-482 ◽  
Author(s):  
Benjamin D. Aronson ◽  
Kelley J. Sittner ◽  
Melissa L. Walls
Keyword(s):  
Type 2 Diabetes ◽  
Gender Differences ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
American Indian ◽  
Diabetes Distress ◽  
Computer Assisted ◽  
Moderating Effects ◽  
The Relationship

Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence are explored. Possible mediating and moderating effects on medication were tested using regression and path analysis. Results. Females had higher levels of DD and DS and lower levels of medication adherence. Higher levels of DD and DS were both associated with lower medication adherence. No evidence was found that gender moderates the relationship between DD or DS and medication adherence. Instead, DD and DS mediated the relationship between gender and medication adherence. Conclusions. Medication adherence differences in male and female patients may be attributable to DD and DS. The present research highlights both DD and DS as targets for clinicians and researchers alike.

The role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in adults with type 2 diabetes

2015 ◽  
Vol 71 (9) ◽  
pp. 2164-2175 ◽  
Author(s):  
Chun-Ja Kim ◽  
Elizabeth A. Schlenk ◽  
Dae Jung Kim ◽  
Moonsun Kim ◽  
Judith A. Erlen ◽  
...  
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
Self Care ◽  
Relationship Of ◽  
The Relationship

scholarly journals Effects of a Multicomponent Life-Style Intervention on Weight, Glycemic Control, Depressive Symptoms, and Renal Function in Low-Income, Minority Patients With Type 2 Diabetes

2016 ◽  
Vol 78 (7) ◽  
pp. 851-860 ◽  
Author(s):  
Ashley E. Moncrieft ◽  
Maria M. Llabre ◽  
Judith Rey McCalla ◽  
Miriam Gutt ◽  
Armando J. Mendez ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Low Income ◽  
Life Style ◽  
Life Style Intervention

The relationship between health literacy and knowledge improvement after a multimedia type 2 diabetes education program

2009 ◽  
Vol 75 (3) ◽  
pp. 321-327 ◽  
Author(s):  
Namratha R. Kandula ◽  
Phyllis A. Nsiah-Kumi ◽  
Gregory Makoul ◽  
Josh Sager ◽  
Charles P. Zei ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Literacy ◽  
Education Program ◽  
Diabetes Education ◽  
The Relationship

scholarly journals The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Lindsay Satterwhite Mayberry ◽  
Cynthia A. Berg ◽  
Kryseana J. Harper ◽  
Chandra Y. Osborn
Keyword(s):  
Type 2 Diabetes ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Family Members ◽  
Self Care ◽  
Text Messages ◽  
User Engagement ◽  
Mhealth Intervention ◽  
Care Support

Family members’ helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant’s (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n=7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.

scholarly journals The MEssaging for Diabetes Intervention Reduced Barriers to Medication Adherence Among Low-Income, Diverse Adults With Type 2

2016 ◽  
Vol 11 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Lindsay S. Mayberry ◽  
Shelagh A. Mulvaney ◽  
Kevin B. Johnson ◽  
Chandra Y. Osborn
Keyword(s):  
Medication Adherence ◽  
Low Income ◽  
Text Messages ◽  
Self Report ◽  
Mhealth Intervention ◽  
Adherence Assessment ◽  
Diabetes Intervention ◽  
The Cost ◽  
Nested Regression

Background: Nonadherence to diabetes medication is prevalent and costly. MEssaging for Diabetes (MED), a mobile health (mHealth) intervention, identified and addressed user-specific barriers to medication adherence. We assessed whether MED reduced users’ targeted barriers and if barrier reductions were associated with within-participant improvements in adherence or glycemic control (HbA1c). Methods: Adults (N = 80) with type 2 diabetes completed self-report measures identifying barriers to adherence at baseline and monthly for 3 months. At each assessment, 17 barriers were assessed and ranked for each user. Each subsequent month, users received daily text messages addressing their 3 highest ranked barriers. Targeted barriers were different for each participant and could change monthly. Paired t-tests assessed within-participant improvement in targeted barriers each month, and nested regression models assessed if changes in a participant’s barrier scores were associated with improvements in adherence and HbA1c. Results: Participants were 69% non-white and 82% had incomes <$25K. Average HbA1c was 8.2 ± 2.0%. Assessment completion rates were 100% at baseline, 59% at 1 month, 30% at 2 months, and 65% at 3 months. The most commonly reported barriers were the cost of medications (76%), believing medications are harmful (58%), and lacking information about medications (53%). Participants’ barrier scores improved each month and barrier improvement predicted adherence assessed via nightly adherence assessment text messages ( P < .001). Among participants who completed assessments each month, barrier improvement in months 2 and 3 ( P < .05) predicted HbA1c improvement. Conclusions: Iterative, individual tailoring may overcome users’ barriers to adherence. Attrition is a challenge for mHealth interventions among low-income patients.

scholarly journals Relationship Between Social Capital and Depressive Symptoms Among Type 2 Diabetes Mellitus Patients in Northwest China: A Mediating Role of Sleep Quality

2021 ◽  
Vol 12 ◽  
Author(s):  
Liqun Wang ◽  
Jiangping Li ◽  
Yuqi Dang ◽  
Haiyu Ma ◽  
Yang Niu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Northwest China ◽  
Mediating Role ◽  
The Relationship

Objective: There are few studies about the relationship between social capital (SC) and depression among type 2 diabetes mellitus (T2DM) patients, and the mechanism explaining how SC leads to decreased depression is unclear. The current study aims to explore the relationship between SC and depressive symptoms among the T2DM patients in northwest China, with a particular focus on the mediating role of sleep quality.Methods: A cross-sectional study of 1,761 T2DM patients from Ningxia Province was conducted. The Center for Epidemiological Survey Depression Scale (CES-D) and self-report sleep quality questionnaire coupled with the SC scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model.Results: The prevalence of depressive symptoms among T2DM patients was 24.8%. After controlling for covariates, the SC (r = −0.23, p &lt; 0.001) was negatively correlated with CES-D score; the sleep quality was also negatively correlated with CES-D score (r = −0.31, p &lt; 0.001); and the SC was positively correlated with sleep quality (r = 0.10, p &lt; 0.001). Logistic regression analysis showed that SC was inversely related to the risk of depressive symptoms. Meanwhile, sleep quality was negatively associated with depressive symptoms. Sleep quality has mediated the relationship between SC and depressive symptoms among T2DM patients (explaining 12.6% of the total variance).Conclusions: We elucidated how SC interacted with depressive symptoms through the mediation pathway of sleep quality using a representative sample of the Chinese diabetes patients. The findings indicate that the improvement of SC and sleep quality may help in maintaining mental health among T2DM patients. Hence, clinicians can suggest that patients communicate more with others to improve the SC and, in turn, maintain their health.

scholarly journals Clinical variables associated with depression in patients with type 2 diabetes

2015 ◽  
Vol 61 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Mari Cassol Ferreira ◽  
Camila Piaia ◽  
Ana Carolina Cadore ◽  
Marinez Amabile Antoniolli ◽  
Geni Portela Gamborgi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Peripheral Neuropathy ◽  
Metabolic Control ◽  
Antidepressant Treatment ◽  
Clinical Impact ◽  
Control Group ◽  
Increased Risk ◽  
The Relationship

SummaryBackground:the aim of the study was to evaluate the relationship between type 2 diabetes (T2DM), depression and depressive symptoms and their clinical impact on T2DM.Methods:the authors evaluated 214 outpatients, 105 with diabetes (T2DM group) and 109 non-diabetics (control group), with ages ranging between 50 and 75 years (T2DM group 65.1 ± 5.6 years, control group 63.4 ± 5.8 years). Use of antidepressant treatment or score ≥ 16 on the Beck depression inventory (BDI) was considered depression. Complications of diabetes and total symptom score (TSS) for peripheral neuropathy were reported by patients.Results:diabetes group had a higher frequency of depression (35.2%) compared to controls (21.1%) (p=0,021), with 2.4 times increased risk of depression. The presence of depressive symptoms was also higher in T2DM group (mean BDI 9.5 ± 8.8 versus 6.9 ± 6.2; p=0.039). Symptoms of diabetic neuropathy were higher in depressed subjects. The metabolic control and presence of complications in T2DM group were not associated with depression.Conclusion:T2DM led to an increased risk of depression, but this did not influence the metabolic control or the presence of other complications.

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