Improving diabetes care for young people with type 1 diabetes through visual learning on mobile phones: mixed-methods study.
Improving diabetes care for young people with type 1 diabetes through visual learning on mobile phones: mixed-methods study.
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DOI：
10.2196/jmir.2155
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发表时间：
2012-08-06
影响因子：
7.4
通讯作者：
Skårderud F
中科院分区：
文献类型：
--
作者：
Frøisland DH;Arsand E;Skårderud F
只有17%的挪威儿童和青少年糖尿病患者达到了糖化血红蛋白（HbA 1c）测量的国际治疗目标。传统的医患咨询似乎不太适合幼儿。需要测试和评估更适合年轻人的新战略，以改善对青少年糖尿病自我管理的支持。(1)探讨移动的手机应用程序如何用于青少年1型糖尿病患者的随访，以及（2）使用研究结果来指导应用程序的进一步开发，并作为未来研究的基础。我们对两个移动的电话应用程序进行了试点测试：（1）包含基于图片的糖尿病日记的应用程序，用于记录身体活动和用手机相机拍摄的所吃食物的照片，其中手机还通过蓝牙技术与血糖仪通信以捕获血糖值，以及（2）基于Web的、密码安全的和加密的短消息服务（SMS），基于使用通过SMS接收的登录密码的访问，当参与者在日常生活中遇到障碍时，参与者使用登录密码向其提供者发送消息，并向参与者发送教育消息。在为期3个月的试点研究结束时，12名年龄在13-19岁的参与者（7名女孩和5名男孩）完成了半结构化访谈。受试者的平均HbA 1c值为8.3（SD 0.3），平均年龄为16.2（SD 1.7）岁，平均体重指数为23.3（SD 3.2）kg/m2，平均糖尿病病程为7.5（SD 4.6）年。我们应用了三个额外的测量：通过HbA 1c测量的代谢控制变化，系统可用性量表和糖尿病知识。从访谈中，出现了三个主要类别：可视化，访问和软件更改。与短信解决方案相比，参与者更喜欢基于图片的日记。在移动的日记中可视化糖尿病自我护理的基础（即饮食、胰岛素剂量、体力活动和餐前和餐后血糖测量结果都转换为一张图片）被认为是通过行动反思的重要教育工具。这导致了参与者对其疾病管理的应用知识的变化。额外的测量补充并支持了定性结果。然而，通过基于国家健康信息学糖尿病测验的27项问卷调查，干预前后HbA 1c和参与者理论知识的变化没有统计学意义（分别为P = .38和P = .82，配对样本t检验）。与会者提出了额外的功能，我们将在下一代软件的设计中实现这一点。参与者报告对应用知识的理解有所增加，这似乎对糖尿病自我护理产生了积极影响。视觉印象似乎很好地适应了青少年大脑的成熟，促进了理论知识和执行功能之间的联系。短信给青少年增加了访问和安全的感觉。与会者为进一步开发这些应用程序提供了宝贵的投入。
Only 17% of Norwegian children and adolescents with diabetes achieve international treatment goals measured by glycated hemoglobin (HbA1c). Classic patient–physician consultations seem to be poorly adapted to young children. New strategies that are better attuned to young people to improve support of adolescents’ self-management of diabetes need to be tested and evaluated. (1) To explore how applications for mobile phones can be used in follow-up of adolescents with type 1 diabetes, and (2) to use the findings to guide further development of the applications and as a basis for future studies. We pilot tested two mobile phone applications: (1) an application that contained a picture-based diabetes diary to record physical activity and photos taken with the phone camera of food eaten, where the phone also communicated with the glucometer by Bluetooth technology to capture blood glucose values, and (2) a Web-based, password-secured and encrypted short message service (SMS), based on access using login passwords received via SMS to be used by participants to send messages to their providers when they faced obstacles in everyday life, and to send educational messages to the participants. At the end of the 3-month pilot study, 12 participants (7 girls and 5 boys ) aged 13–19 years completed semistructured interviews. The participants had a mean HbA1c value of 8.3 (SD 0.3), mean age of 16.2 (SD 1.7) years, mean body mass index of 23.3 (SD 3.2) kg/m2, and mean diabetes duration of 7.5 (SD 4.6) years. We applied three additional measurements: change in metabolic control as measured by HbA1c, the System Usability Scale, and diabetes knowledge. From the interviews, three main categories emerged: visualization, access, and software changes. Participants appreciated the picture-based diary more than the SMS solution. Visualization of cornerstones in diabetes self-care (ie, diet, insulin dosage, physical activity, and pre- and postprandial glucose measurements all transformed into one picture) in the mobile diary was found to be an important educational tool through reflections in action. This led to a change in participants’ applied knowledge about the management of their disease. Additional measurements supplemented and supported the qualitative findings. However, changes in HbA1c and participants’ theoretical knowledge as tested by a 27-item questionnaire, based on a national health informatics’ diabetes quiz, before and after the intervention were not statistically significant (P = .38 and P = .82, respectively, paired-samples t test). Participants suggested additional functionality, and we will implement this in the design of the next software generation. Participants reported an increased understanding of applied knowledge, which seem to positively affect diabetes self-care. Visual impressions seem well adapted to the maturation of the adolescent brain, facilitating the link between theoretical knowledge and executive functions. SMS gave the adolescents a feeling of increased access and security. Participants gave valuable input for further development of these applications.
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DOI：
10.1073/pnas.0402680101
发表时间：
2004-05-25
影响因子：
11.1
作者：
Gogtay, N;Giedd, JN;Thompson, PM
通讯作者：
Thompson, PM
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
7.4
作者：
Chomutare T;Fernandez-Luque L;Arsand E;Hartvigsen G
通讯作者：
Hartvigsen G
影响因子：
7.4
作者：
Cafazzo JA;Casselman M;Hamming N;Katzman DK;Palmert MR
通讯作者：
Palmert MR
影响因子：
7.4
作者：
Franklin, Victoria Louise;Greene, Alexandra;Pagliari, Claudia
通讯作者：
Pagliari, Claudia