Patients' Engagement With "Sweet Talk" - A Text Messaging Support System for Young People With Diabetes
Patients' Engagement With "Sweet Talk" - A Text Messaging Support System for Young People With Diabetes
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DOI：
10.2196/jmir.962
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发表时间：
2008-01-01
影响因子：
7.4
通讯作者：
Pagliari, Claudia
中科院分区：
文献类型：
--
作者：
Franklin, Victoria Louise;Greene, Alexandra;Pagliari, Claudia
背景：优化年轻人1型糖尿病的指南提倡强化胰岛素治疗，并辅之以卫生保健团队的个人支持。“甜言蜜语”是一种新颖的干预措施，旨在通过向手机发送短信来支持就诊期间的患者。预定的消息是根据患者个人资料和糖尿病自我管理目标量身定做的，通用消息包括主题“时事通讯”和来自其他参与者的匿名提示。该系统还允许患者向糖尿病护理团队提交数据和问题。目的：探讨1型糖尿病患者如何与Sweet Talk系统互动，以了解其对这一用户群体的效用。方法：受试者为参加随机对照试验的青少年糖尿病患者。在12个月的时间里，所有提交给Sweet Talk的短信都被记录下来。结果：患者在观察期内提交了180条信息，平均18.4条，中位数6条。参与者之间的消息传递频率差异很大(0-240)，5个高用户子集贡献了总数的52%。患者的临床和社会人口学特征与总的信息发送频率无关，尽管女孩发送的与糖尿病无关的消息明显多于男孩(P=0.002)。患者消息的内容主要分为8类：血糖读数、糖尿病问题、糖尿病信息、个人健康管理、社交消息、技术消息、消息错误和消息回复。非提示提交血糖值是最常见的来电类型(占总数的35%)。对个人经历和小贴士的请求的回复产生了所有收到的消息的40%，而热门新闻也产生了良好的反应。患者还使用这项服务提出问题，提交有关自我管理的信息，并订购用品。没有患者提名支持者接收关于他们自我管理目标的短信。另一个没有使用的选项是生日提醒服务。结论：自动化的预定短信成功地吸引了患有糖尿病的年轻人。虽然该系统的设计初衷是为患者提供“推送”支持，但提交临床数据和查询表明，该系统被视为与护理提供者沟通的可靠媒介。对时事通讯的回应以及向其他参与者分发个人经验和技巧也说明了这种干预措施对建立社区意识的潜在价值。虽然参与者提交的信息相对较少，但对该系统的积极回应表明，大多数人从阅读信息中获得被动支持。甜言蜜语系统可以很容易地适应其他慢性病模型和年龄组，这项研究的结果可能有助于为未来短信支持干预措施的设计提供信息。
Background: Guidelines for optimizing type 1 diabetes in young people advocate intensive insulin therapy coupled with personal support from the health care team. "Sweet Talk" is a novel intervention designed to support patients between clinic visits using text messages sent to a mobile phone. Scheduled messages are tailored to patient profiles and diabetes self-management goals, and generic messages include topical "newsletters" and anonymized tips from other participants. The system also allows patients to submit data and questions to the diabetes care team.Objectives: The aim was to explore how patients with type 1 diabetes interact with the Sweet Talk system in order to understand its utility to this user group.Methods: Subjects were 64 young people with diabetes who were participating in the intervention arms of a randomized controlled trial. All text messages submitted to Sweet Talk during a 12-month period were recorded. Messaging patterns and content were analyzed using mixed quantitative and qualitative methods.Results: Patients submitted I 180 messages during the observation period (mean 18.4, median 6). Messaging frequency ranged widely between participants (0-240) with a subset of 5 high users contributing 52% of the total. Patients' clinical and sociodemographic characteristics were not associated with total messaging frequency, although girls sent significantly more messages unrelated to diabetes than did boys (P =.002). The content of patients' messages fell into 8 main categories: blood glucose readings, diabetes questions, diabetes information, personal health administration, social messages, technical messages, message errors, and message responses. Unprompted submission of blood glucose values was the most frequent incoming message type (35% of total). Responses to requests for personal experiences and tips generated 40% of all the incoming messages, while topical news items also generated good responses. Patients also used the service to ask questions, submit information about their self-management, and order supplies. No patients nominated supporters to receive text messages about their self-management goals. Another option that was not used was the birthday reminder service.Conclusions: Automated, scheduled text messaging successfully engaged young people with diabetes. While the system was primarily designed to provide "push" support to patients, submission of clinical data and queries illustrates that it was seen as a trusted medium for communicating with care providers. Responses to the newsletters and submission of personal experiences and tips for circulation to other participants also illustrate the potential value of such interventions for establishing a sense of community. Although participants submitted relatively few messages, positive responses to the system suggest that most derived passive support from reading the messages. The Sweet Talk system could be readily adapted to suit other chronic disease models and age groups, and the results of this study may help to inform the design of future text message support interventions.