Working Toward an mHealth Platform for Adolescents with Type 1 Diabetes: Focus Groups With Teens, Parents, and Providers

2020 ◽  
Vol 46 (5) ◽  
pp. 444-454
Author(s):  
Manuela Sinisterra ◽  
Katherine Patterson Kelly ◽  
Caitlin Shneider ◽  
Ashley El-Zein ◽  
Ellen Swartwout ◽  
...  

Purpose The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform. Methods Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors. Results Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families. Conclusion Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.

2017 ◽  
Vol 44 (1) ◽  
pp. 72-82 ◽  
Author(s):  
Robin Whittemore ◽  
Rebekah M. Zincavage ◽  
Sarah S. Jaser ◽  
Margaret Grey ◽  
Julia L. Coleman ◽  
...  

Purpose The purpose of this study was to understand the experience of parenting an adolescent with type 1 diabetes (T1DM), to develop a prototype of an eHealth program for parents of adolescents with T1DM, and to evaluate the prototype content and acceptability from the perspective of parents and health care providers. Methods A multiphase method was used generating both qualitative and quantitative data at multiple time points. There were 27 parents of adolescents aged 12 to 18 years with T1DM and 16 health care providers who participated in semistructured interviews to identify parental challenges; 53 parents and 27 providers evaluated the prototype. Thematic content analysis was used to analyze interview transcripts, and descriptive statistics were used to summarize survey data. Results Challenges experienced by parents of adolescents with T1DM included understanding the developmental and hormonal changes of adolescence that affect diabetes care, feeling tension between adolescent independence and parent control, communicating without nagging or conflict, transferring diabetes care responsibility safely, dealing with feelings of stress and distress, and perceiving a lack of resources for T1DM care and insufficient personal time for self-care. In the prototype evaluation, both parents and providers found content to be relevant and provided feedback to guide the development of the full program. Conclusions Parents of adolescents with T1DM and providers expressed a need for parents to have more support in transitioning diabetes care from parent to adolescent. eHealth programs offer an ideal way to address these needs and ultimately can be linked to electronic medical records improving quality and efficiency of health care in this population.


2018 ◽  
Vol 1 (1) ◽  
pp. 1-20
Author(s):  
Andi Mayasari Usman ◽  
Rian Adi Pamungkas

Diabetes mellitus is one of the global problems the world. Since the complexity of the patient’s tasks is required in the diabetes care, the consistency to engage this various health behavior for addressing the glycemic control target is difficult to achieve. Failure management may reflect by patient, family, inadequate intervention strategies by health care provider as well as organization factor. Three databases used such as PubMed, MIDLINE, and CINAHL to address patient’s barriers, family’s barriers, and provider’s barriers as well as organization barriers for diabetes management. Patient’s attitudes and belief, knowledge, culture, and ethnicity, self-efficacy, financial resources and economic status, lack of Social Support Perceived, and lack of time may influence the diabetes self-management. Family factors lead to patients’ diabetes self-management such as lack of knowledge and skill to support patients in diabetes management and quality of the relationship between patients-family. Health care providers factors included beliefs, attitudes, knowledge and skill and patient–family-provider interaction and communication. Other factors lead to diabetes self-management and health care provider performance to provide the intervention from organization level such as integrated health system sufficiency health insurance to support resources. A deeper understanding of the barriers in diabetes management is necessary to improve the diabetes care and quality of health care services for patients with diabetes. Further research needs to consider these barriers before designing the effective, sensitive interventions and problem solving for diabetes care


2021 ◽  
Author(s):  
Satoshi Inagaki ◽  
Kenji Kato ◽  
Kozue Abe ◽  
Takeshi Kawamoto ◽  
Hiroaki Takahashi ◽  
...  

BACKGROUND Background: Healthcare apps on smartphones are used to retrieve health information and manage health. A number of healthcare apps have been employed to support diabetes self-management, and evidence has accumulated on the outcomes of interventions using individual apps. However, only a small percentage of all healthcare apps have a proven effect on people with diabetes, and it is unclear which apps should be recommended in non-English-speaking countries. Verifying that the healthcare apps used by people with diabetes are useful for diabetes management behaviors will help healthcare providers know which apps to recommend. OBJECTIVE Objective: The purpose of this study was to clarify whether and how the use of healthcare apps affects the self-management behavior of people with diabetes. METHODS Methods: A cross-sectional questionnaire was given to patients with type 2 diabetes who were pre-registered with an Internet research company. The items on the questionnaire involved the use of smartphone healthcare apps, diabetes self-management behaviors (Japan Summary of Diabetes Self-Care Activities [J-SDSCA]), motivations for diabetes self-management (autonomous motivation and controlled motivation), and feelings of competence in self-management (Perceived Competence for Diabetes Scale). To examine whether a healthcare app had an effect on the self-management behavior score, a multiple regression analysis was conducted with the J-SDSCA score as the objective variable. RESULTS Results: Of the 253 participants, 61 (24.1%) indicated that they were currently using a healthcare app. Those using a healthcare app had a significantly higher J-SDSCA score than those not using one (beta =.15, 95% CI 0.60–3.54, P <.001). Regarding the frequency of exercise, the use of apps for steps and walking distance led to a significant difference (beta =.22, 95% CI 0.59–1.90, P <.001). For general diet, the use of any healthcare app had no significant effect (P =.22). CONCLUSIONS Conclusions: The use of healthcare apps was beneficial for diabetes self-management. Given that even non-specialized apps can improve diabetes self-management behaviors, health care providers should encourage patients to use apps that are tailored to their preferences and that are easy to use long-term. The use of healthcare apps was particularly associated with increased exercise regimen efforts. Recommending the use of healthcare apps, especially apps that include pedometers, could be useful when patients have problems with exercise.


2020 ◽  
Vol 16 ◽  
Author(s):  
Sorour Salehi Baghbaderani ◽  
Parastou Mokarian ◽  
Parisa Moazzam

Background: Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Methods: Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Results: Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals' privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. Conclusion: The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact.


2020 ◽  
Vol 59 (4-5) ◽  
pp. 388-395
Author(s):  
Samantha P. Bento ◽  
MaryJane S. Campbell ◽  
Olivia Soutullo ◽  
Fran R. Cogen ◽  
Maureen Monaghan

Pediatric health care providers are in a unique position to discuss the health implications of alcohol, tobacco, and drug use with adolescents and young adults (AYAs) with type 1 diabetes (T1D). This study evaluated the frequency of self-reported substance use and associated demographic and clinical characteristics in a sample of AYAs with T1D and patient-provider discussions of substance use in T1D care. Sixty-four AYAs completed questions about substance use from the Youth Risk Behavior Survey (YRBS). Corresponding diabetes clinic visits were audio-recorded, transcribed, and reviewed to examine substance use discussions. A total of 56.3% of AYAs reported ever engaging in substance use; 40.6% reported substance use within the past 30 days. Five AYAs had discussions about substance use during their most recent diabetes clinic visit. Substance use should be proactively addressed by pediatric health care providers and AYAs should be encouraged to raise questions related to substance use during clinic visits.


2020 ◽  
Vol 163 ◽  
pp. 108153 ◽  
Author(s):  
Eveline R. Goethals ◽  
Sarah S. Jaser ◽  
Chris Verhaak ◽  
Sofie Prikken ◽  
Kristina Casteels ◽  
...  

2018 ◽  
Vol 11 ◽  
pp. 117955141775161 ◽  
Author(s):  
Mussa Hussain Almalki ◽  
Ibtihal Hussen ◽  
Shawana A. Khan ◽  
Abdulrahman Almaghamsi ◽  
Fahad Alshahrani

Background: During Ramadan, Muslims fast from dawn until dusk for one lunar month every year. Most of the Muslim patients with diabetes are unaware of the potential complications that can occur while fasting, such as hypoglycemia. The aim of this study is to assess the the patient education level and patients’ overall awareness of any possible complications that could occur while fasting during Ramadan and to determine how these patients deal with these complications. Methods: We conducted a cross-sectional study and surveyed diabetic patients about their diabetes-related knowledge over a period of 4 months from the outpatient clinic at the Obesity, Endocrine, and Metabolism Center at King Fahad Medical City. Patients were included if they were ≥16 years and if they had been receiving treatment for at least 1 year before the study, irrespective of the medications used; patients were also asked about the presence or absence of complications. Results: This study included 477 patients (325 women and 152 men). Most patients (297; 62.3%) had type 2 diabetes. The patients’ mean age was 39.72 ± 15.29 years, and the mean duration of diabetes was 10.80 ± 5.88 years. During the preceding Ramadan, 76% of patients reported fasting, whereas 58% said that they monitored their blood glucose levels once per day. Hypoglycemic episodes were reported in 60.3% of cases with type 2 diabetes and in 8.3% of cases with type 1 diabetes. Among those who had hypoglycemia, 2.8% of patients with type 1 diabetes and 17.8% with type 2 diabetes broke their fast. Finally, 54% of patients reported that their health care providers offered them instructions on diabetes management during Ramadan. Conclusions: Ramadan health education in diabetes can encourage, improve, and guide patients to change their lifestyles during Ramadan while minimizing the risk of acute complications.


2014 ◽  
Vol 21 (3) ◽  
pp. 234-243 ◽  
Author(s):  
Jessica M. Valenzuela ◽  
Laura B. Smith ◽  
Jeanette M. Stafford ◽  
Ralph B. D’Agostino ◽  
Jean M. Lawrence ◽  
...  

2020 ◽  
Vol 11 (01) ◽  
pp. 070-078
Author(s):  
George Karway ◽  
Maria Adela Grando ◽  
Kevin Grimm ◽  
Danielle Groat ◽  
Curtiss Cook ◽  
...  

Abstract Objectives This article aims to evaluate adult type 1 diabetes mellitus (T1DM) self-management behaviors (SMBs) related to exercise and alcohol on a survey versus a smartphone app to compare self-reported and self-tracked SMBs, and examine inter- and intrapatient variability. Methods Adults with T1DM on insulin pump therapy were surveyed about their alcohol, meal, and exercise SMBs. For 4 weeks, participants self-tracked their alcohol, meal, and exercise events, and their SMBs corresponding with these events via an investigator-developed app. Descriptive statistics and generalized linear mixed-effect models were used to analyze the data Results Thirty-five participants self-tracked over 5,000 interactions using the app. Variability in how participants perceived the effects of exercise and alcohol on their blood glucose was observed. The congruity between SMBs self-reported on the survey and those self-tracked with the app was measured as mean (SD). The lowest congruity was for alcohol and exercise with 61.9% (22.7) and 66.4% (20.2), respectively. Congruity was higher for meals with 80.9% (21.0). There was significant daily intra- and interpatient variability in SMBs related to preprandial bolusing: recommended bolus, p < 0.05; own bolus choice, p < 0.01; and recommended basal adjustment, p < 0.01. Conclusion This study highlights the variability in intra- and interpatient SMBs obtained through the use of a survey and app. The outcomes of this study indicate that clinicians could use both one-time and every-day assessment tools to assess SMBs related to meals. For alcohol and exercise, further research is needed to understand the best assessment method for SMBs. Given this degree of patient variability, there is a need for an educational intervention that goes beyond the traditional “one-size-fits-all” approach of diabetes management to target individualized treatment barriers.


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