Self-Monitoring Support Application for Adults with Diabetes and Hypertension

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PROJECT SUMMARY/ABSTRACT The purpose of this project is to develop a theory-drien, voice-activated, scalable, mHealth intervention to promote self-management and patient-provider communication in patients with coexisting diabetes (DM) and hypertension (HTN). Among the 30 million Americans who have DM, more than 20 million also have HTN. Self- management of chronic conditions is a promising strategy for preventing the development of additional co- occurring diseases and resulting in reduced morbidity and mortality. Self-monitoring health indicators (e.g., blood pressure [BP], glucose) is a key component of successful self-management. Through self-monitoring, patients can recognize patterns in their health indicators, obtain more health information, and change health behaviors. To meet the self-management needs of individuals with comorbid DM and HTN, we propose to develop a voice-activated self-monitoring (VoiS) support application on a smart speaker platform that includes three types of fearues 1) self-monitoring features, including voice-activated data entry (i.e., glucose and BP), smart notes to record lifestyle-related episodes that could result in unusual values of biomarkers, and smart speech reminders; 2) clinical decision support features, including an evidence-based knowledge base with AI engine for DM and for HTN, and 3) shared decision-making features, including visualization of patient data on multiple platforms and an audio briefing of patient data on a smart speaker. We hypothesize that patients with coexisting DM and HTN will use the convenient VoiS app for routine self-monitoring of biomarkers and for recording lifestyle-related episodes. Other hypotheses are: (1) the synthesized patient data produced by the VoiS app will help patients better understand the status of their conditions; and (2) patient-generated data-sharing via the VoiS app will help patients and providers effectively communicate with each other, set shared goals, and choose personalized care plans to promote adherence to treatment. Before we can verify the clinical efficacy of this theory-based mHealth self-management intervention, we first need to develop the VoiS. Therefore, aims of this study are to 1) develop the VoiS app including the three features; and 2) test acceptability and usability of the VoiS app in the lab and in the field by patients with coexisting DM and HTN. Findings from this project will enhance our understanding of user-perceived acceptance, usability, and satisfaction with the VoiS app. Additionally, findings will be used to generate another R21 application to move this research forward through pilot testing to determine preliminary clinical efficacy using a randomized design. We anticipate that this project will contribute to reduce racial and socioeconomic disparities in self-monitoring and outcomes for patients with DM and HTN that are indicated by delayed access to care; and inform the replication of this work for other coexisting metabolilc chronic conditions.