HIT for Facilitating Problem Solving in Diabetes Management

描述(由申请人提供)：在这项研究中，我们建议开发和评估一种新的决策支持工具，它将使用交互式网站和短信消息服务器的组合来促进糖尿病问题的解决。过去的研究已经提供了令人信服的证据，表明良好的解决问题的能力对于成功的糖尿病管理、导致更好的糖尿病自我护理行为以及帮助糖尿病患者改善健康至关重要。健康信息技术(HIT)可以帮助个人发展必要的解决问题的能力。然而，目前许多HIT干预措施的目标是改善患者与临床医生的沟通，改善记录和监测，而不是更具体地关注培养解决问题的技能。这项研究的长期目标是开发有理论基础、基于实践的HIT干预措施，以促进通过解决问题、实验和发现来实现糖尿病自我管理。在我们之前的工作中，我们确定了一套糖尿病教育工作者用来促进糖尿病问题解决的策略。在这个项目中，我们将使用这些策略来开发决策支持工具--移动糖尿病检测(MOD)--它将帮助糖尿病患者识别糖尿病管理中特定的、对个人有重大意义的挑战(如空腹血糖(BG)值过高)，生成应对这些挑战的替代策略(如引入睡前零食)，通过简单的实验(如测量感兴趣的活动前后的血糖)来评估这些策略，以及监控它们的结果(通过交互式可视化或简单的文字摘要)。互动网站上的向导式界面将帮助个人制定个人学习计划。发给个人手机的短信将提醒他们计划中的实验，并允许报告实验结果。MOD将使用一个用于慢性病自我管理的开源平台来构建(万岁！)由研究团队开发；我们计划将结果工具发布给研究社区。我们将在随机对照试验(RCT)中评估MOD的有效性，并使用RE-AIM框架评估其潜在的公共卫生影响。

DESCRIPTION (provided by applicant): In this research we propose to develop and evaluate a new breed of decision-support tools that will facilitate problem-solving in diabetes using a combination of an interactive website and SMS messaging server. Past research has provided convincing evidence that well-developed problem-solving abilities are essential to successful diabetes management, result in better diabetes self-care behaviors, and help individuals with diabetes improve their health. Health Information Technology (HIT) can assist individuals in developing the necessary problem-solving abilities. At present, however, many HIT interventions target improved patient- clinician communication and improved logging and monitoring, rather than focusing more specifically on fostering problem-solving skills. The long term goal of this research is to develop theoretically-grounded, practice-based HIT interventions for facilitating effecting diabetes self-management through problem-solving, experimentation, and discovery. In our prior work we identified a set of strategies used by diabetes educators to foster diabetes problem-solving. In this project we will use these strategies to develop a decision-support tool-Mobile Diabetes Detective (MoDD)-that will help individuals with diabetes to identify specific, personally significant challenges in diabetes management (such as undesirably high fasting Blood Glucose (BG) values), generate alternative strategies for addressing these challenges (such as introducing a bedtime snack), evaluate these strategies through simple experiments (measuring BG before and after an activity of interest), and monitor their outcomes (through interactive visualization or simple textual summary). A wizard-like interface on an interactive website will help individuals develop personal learning plans. SMS messages to individuals' mobile phones will remind them of the planned experiments and allow reporting the results of the experiments. MoDD will be built using an open source platform for chronic disease self- management (Salud!) developed by the research team; we plan to release the resulting tool to the research community. We will evaluate the effectiveness of MoDD in a Randomized Controlled Trial (RCT) and assess its potential public health impact using RE-AIM framework.