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，该工具将使用交互式网站和短信服务器的组合来促进糖尿病问题的解决。过去的研究提供了令人信服的证据，证明良好的解决问题的能力对于成功的糖尿病管理是必不可少的，导致更好的糖尿病自我护理行为，并帮助糖尿病患者改善他们的健康。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。本研究的长期目标是发展理论基础的、基于实践的HIT干预措施，通过解决问题、实验和发现来促进糖尿病自我管理。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一个决策支持工具——移动糖尿病检测（MoDD）——这将帮助糖尿病患者识别糖尿病管理中具体的、个人重大的挑战（如不受欢迎的高空腹血糖（BG）值），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（在感兴趣的活动之前和之后测量BG）评估这些策略，并监测其结果（通过交互式可视化或简单的文本摘要）。交互式网站上的向导式界面将帮助个人制定个人学习计划。向个人手机发送的短信将提醒他们计划中的实验，并允许报告实验结果。MoDD将使用研究团队开发的慢性病自我管理开源平台（Salud!）进行构建；我们计划将生成的工具发布给研究社区。我们将在一项随机对照试验（RCT）中评估MoDD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.