scholarly journals Development and Usability of a Text Messaging Program for Women with Gestational Diabetes: Mixed Methods Study (Preprint)

10.2196/32815 ◽  
2021 ◽  
Author(s):  
Rachel A. Blair ◽  
Christine E. Horn ◽  
Jennifer M. Dias ◽  
Marie E. McDonnell ◽  
Ellen W. Seely
2020 ◽  
Author(s):  
Shilpa Surendran ◽  
Chang Siang Lim ◽  
Gerald Choon Huat Koh ◽  
Tong Wei Yew ◽  
E Shyong Tai ◽  
...  

BACKGROUND The prevalence of gestational diabetes mellitus (GDM) is increasing in Singapore and the cost of providing traditional care for GDM is high. Mobile health (mHealth) applications may act as useful tools in the management of GDM. OBJECTIVE The objective of this mixed-methods study was to measure the usage behaviour and explore users’ perceived usefulness of the Habits-GDM application when managing GDM in a randomised controlled trial. METHODS We conducted a quantitative analysis of the application usage behaviour in 170 Habits-GDM application users and 14 semi-structured interviews with users from a randomised controlled trial. RESULTS The convenience of automatic data transfer of weight values to the Habits-GDM application helped users (116/170, 68%) log their weight at least once a week. However, when the application had usability challenges, users avoided using that feature, i.e. users logged only an average of less than one meal/week out of the recommended six meals/week. Of the usability challenges, many users (12/14, 85.7%) mentioned food items not worded in the commonly known way and limited ethnic food database as the primary barriers. Only half of the users (84/170, 49.4%) accessed the educational lessons, but many (9/14, 64%) identified the provision of always available, valuable health-related information as an advantage of the educational lessons. ‘Healthy eating’ and ‘Why exercise’ were the most (56/84, 66.67%) and least (38/84, 45.24%) frequently accessed educational lessons, respectively. Users (10/14, 71.4%) reported sending messages to the coach via the chat interface only when they faced logistic issues and 86.45% of all the coach messages were replies typed by the research coordinator in response to the logistics issues (i.e. a request for blood glucose testing strips and appointment confirmation) raised by the users. Healthcare professionals lack of access to the coach’s dashboard discouraged users from asking queries related to GDM via the e-coaching feature. CONCLUSIONS The findings suggest that mHealth application acts as a useful tool in managing GDM. Culturally sensitive mHealth applications with a provision for women to interact with healthcare professionals should be developed in cooperation with the users. CLINICALTRIAL Not applicable.


Author(s):  
Shilpa Surendran ◽  
Chang Siang Lim ◽  
Gerald Choon Huat Koh ◽  
Tong Wei Yew ◽  
E Shyong Tai ◽  
...  

The prevalence of gestational diabetes mellitus (GDM) is increasing, and only a few mobile health (mHealth) applications are specifically designed to manage GDM. In this mixed-methods study, a follow-up study of a randomized controlled trial (RCT) analyzed a largely automated mHealth application-based lifestyle coaching program to (a) measure the application’s usage behavior and (b) explore users’ perceptions of its usefulness in GDM management. Quantitative data were collected from the 170 application users who had participated in the intervention arm of the RCT. Semi-structured interviews (n = 14) captured users’ experiences when using the application. Data were collected from June 2019 to January 2020. Quantitative data were analyzed descriptively, and interviews were analyzed thematically. Only 57/170 users (34%) logged at least one meal, and only 35 meals on average were logged for eight weeks because of the incorrectly worded food items and limited food database. On the contrary, an average of 1.85 (SD = 1.60) weight values were logged per week since the weight tracking component was easy to use. Many users (6/14 (43%)) mentioned that the automatic coach messages created an immediate sense of self-awareness in food choices and motivated behavior. The findings suggest that for GDM management, a largely automated mHealth application has the potential to promote self-awareness of healthy lifestyle choices, reducing the need for intensive human resources. Additionally, several gaps in the application’s design were identified which need to be addressed in future works.


2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 155-155
Author(s):  
Echo L. Warner ◽  
Brynn Fowler ◽  
Samantha Pannier ◽  
Douglas Beaty Fair ◽  
Holly Perlman ◽  
...  

155 Background: We describe patient navigator preferences for adolescent and young adult (AYA) cancer patients by geographical distance from cancer treatment centers. Methods: In this mixed methods study, N = 39 participants were recruited primarily from oncology clinics in Utah. Participants were diagnosed between ages 15-39 and had completed ≥ 1 month of treatment. Participants were interviewed and surveyed on preferences for patient navigation. Thematic content analysis revealed navigation preferences based on participants’ travel distance from their treatment center, classified as < 20 miles (local) and ≥ 20 miles (distance). Qualitative data was quantized and the proportion of codes in each theme was compared by travel distance using two-tailed z-scores. Results: Mean travel distance to cancer treatment center was 53.5 miles (SD = 77.4); 53.8% of participants were local ( < 20 miles) and 46.2% were distance ( ≥ 20 miles). There were no differences by age or ethnicity. Local patients were less likely to endorse that travel distance was a challenge for their oncology appointments than distance patients (25.0% vs. 75.0%, p = 0.01). Local patients reported a higher proportion of codes (62.5%) related to believing a patient navigator would be helpful to them compared to distance patients (37.5%, p = 0.01). Connecting with a patient navigator at the time of first diagnosis was endorsed by more local patients than distance (66.7% vs. 33.3%, p = 0.01). Local patients reported a greater need for navigation support regarding finances (local 69.6% vs. distance 30.4%, p = < 0.001) and social support (local 87.5% vs. distance 12.5%, p = 0.03). Most participants, regardless of travel distance, desired navigation primarily via telephone (audio and text messaging). Conclusions: While AYAs with cancer living further from their treatment location were more likely to report that travel was a barrier, local AYAs reported more needs related to patient navigation than remote patients. Patient navigators may need to consider different support services for distanced patients including strategies to address geographic barriers to care.


2019 ◽  
Author(s):  
Sumali Hewage ◽  
Jananie Audimulam ◽  
Emily Sullivan ◽  
Claudia Chi ◽  
Tong Wei Yew ◽  
...  

BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. OBJECTIVE This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. METHODS This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. RESULTS The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (210/214, 98.1%), and receiving support and information from the GDM clinic (194/215, 90.2%) and web-based sources (131/215, 60.9%). In particular, working women reported barriers to GDM management, including the lack of reminders for blood glucose monitoring, diet control, and insufficient time for exercise. Most women preferred getting such support directly from health care providers, whether at the GDM clinic (174/215, 80.9%) or elsewhere (116/215, 53.9%). Smartphone apps were the preferred means of additional intervention. Desirable intervention features identified by patients included more information on GDM, diet and exercise options, reminders for blood glucose testing, a platform to record blood glucose readings and illustrate or understand trends, and a means to communicate with care providers. CONCLUSIONS A GDM-focused smartphone app that is able to integrate testing, education, and communication may be a feasible and acceptable intervention to provide support to women with GDM, particularly for working women.


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