David V Wagner1, Samantha A Barry2, Maggie Stoeckel3, Lena Teplitsky1, Michael A Harris1,4. 1. 1 Oregon Health & Science University, Portland, OR, USA. 2. 2 University of Massachusetts Medical Center, Diabetes Center of Excellence, Worcester, MA, USA. 3. 3 Seattle Children's Hospital, University of Washington, Seattle, WA, USA. 4. 4 Harold Schnitzer Diabetes Health Center, Portland, OR, USA.
Abstract
BACKGROUND: There is growing evidence for the feasibility of text-based interventions for pediatric patients with type 1 diabetes (T1D). However, less is known regarding whether the use of personalized text messages with high-risk youth and their caregivers is associated with improvements in youth health. This study examines the use of diabetes-specific texts and associated health outcomes for participants of the Novel Interventions in Children's Healthcare (NICH) program. METHODS: Text messages sent to youth with T1D and their caregivers during NICH intervention were coded regarding diabetes relevance and adherence-related content. Health outcome data (eg, HbA1c values, hospital admissions) prior to and following NICH program enrollment were collected. RESULTS: Fewer than half (43%) of texts sent to patients and their caregivers were identified as being related to diabetes, and over 95% of diabetes-related texts were identified as adherence-related. Participants in the NICH program demonstrated a significant decrease in HbA1c values, t(23) = 2.78, p ≤ .05, and DKA-related hospital visits, t(24) = 2.78, p ≤ .01, during program involvement. Although no relationships were identified between patient-recipient text characteristics and health outcomes, the frequency and type of text messaging with caregivers was significantly associated with changes in health outcomes. CONCLUSIONS: This study represents the most extensive evaluation of diabetes-related SMS use and health outcomes for NICH participants to date. Findings demonstrate improvements in patient health during NICH program involvement. Implications include that sending frequent, personalized, and adherence-reinforcing texts to patients' caregivers may result in improved patient health, decreased utilization, and, potentially, associated reductions in health care costs.
BACKGROUND: There is growing evidence for the feasibility of text-based interventions for pediatric patients with type 1 diabetes (T1D). However, less is known regarding whether the use of personalized text messages with high-risk youth and their caregivers is associated with improvements in youth health. This study examines the use of diabetes-specific texts and associated health outcomes for participants of the Novel Interventions in Children's Healthcare (NICH) program. METHODS: Text messages sent to youth with T1D and their caregivers during NICH intervention were coded regarding diabetes relevance and adherence-related content. Health outcome data (eg, HbA1c values, hospital admissions) prior to and following NICH program enrollment were collected. RESULTS: Fewer than half (43%) of texts sent to patients and their caregivers were identified as being related to diabetes, and over 95% of diabetes-related texts were identified as adherence-related. Participants in the NICH program demonstrated a significant decrease in HbA1c values, t(23) = 2.78, p ≤ .05, and DKA-related hospital visits, t(24) = 2.78, p ≤ .01, during program involvement. Although no relationships were identified between patient-recipient text characteristics and health outcomes, the frequency and type of text messaging with caregivers was significantly associated with changes in health outcomes. CONCLUSIONS: This study represents the most extensive evaluation of diabetes-related SMS use and health outcomes for NICH participants to date. Findings demonstrate improvements in patient health during NICH program involvement. Implications include that sending frequent, personalized, and adherence-reinforcing texts to patients' caregivers may result in improved patient health, decreased utilization, and, potentially, associated reductions in health care costs.
Entities:
Keywords:
NICH; SMS; adolescence; mHealth; text message; type 1 diabetes
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