TY - JOUR
T1 - NICH at Its Best for Diabetes at Its Worst
T2 - Texting Teens and Their Caregivers for Better Outcomes
AU - Wagner, David V.
AU - Barry, Samantha A.
AU - Stoeckel, Maggie
AU - Teplitsky, Lena
AU - Harris, Michael A.
N1 - Publisher Copyright:
© Diabetes Technology Society.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background: There is growing evidence for the feasibility of text-based interventions for pediatric patients with type 1 diabetes (T1D). However, less is known regarding whether the use of personalized text messages with high-risk youth and their caregivers is associated with improvements in youth health. This study examines the use of diabetes-specific texts and associated health outcomes for participants of the Novel Interventions in Children's Healthcare (NICH) program. Methods: Text messages sent to youth with T1D and their caregivers during NICH intervention were coded regarding diabetes relevance and adherence-related content. Health outcome data (eg, HbA1c values, hospital admissions) prior to and following NICH program enrollment were collected. Results: Fewer than half (43%) of texts sent to patients and their caregivers were identified as being related to diabetes, and over 95% of diabetes-related texts were identified as adherence-related. Participants in the NICH program demonstrated a significant decrease in HbA1c values, t(23) = 2.78, p ≤.05, and DKA-related hospital visits, t(24) = 2.78, p ≤.01, during program involvement. Although no relationships were identified between patient-recipient text characteristics and health outcomes, the frequency and type of text messaging with caregivers was significantly associated with changes in health outcomes. Conclusions: This study represents the most extensive evaluation of diabetes-related SMS use and health outcomes for NICH participants to date. Findings demonstrate improvements in patient health during NICH program involvement. Implications include that sending frequent, personalized, and adherence-reinforcing texts to patients' caregivers may result in improved patient health, decreased utilization, and, potentially, associated reductions in health care costs.
AB - Background: There is growing evidence for the feasibility of text-based interventions for pediatric patients with type 1 diabetes (T1D). However, less is known regarding whether the use of personalized text messages with high-risk youth and their caregivers is associated with improvements in youth health. This study examines the use of diabetes-specific texts and associated health outcomes for participants of the Novel Interventions in Children's Healthcare (NICH) program. Methods: Text messages sent to youth with T1D and their caregivers during NICH intervention were coded regarding diabetes relevance and adherence-related content. Health outcome data (eg, HbA1c values, hospital admissions) prior to and following NICH program enrollment were collected. Results: Fewer than half (43%) of texts sent to patients and their caregivers were identified as being related to diabetes, and over 95% of diabetes-related texts were identified as adherence-related. Participants in the NICH program demonstrated a significant decrease in HbA1c values, t(23) = 2.78, p ≤.05, and DKA-related hospital visits, t(24) = 2.78, p ≤.01, during program involvement. Although no relationships were identified between patient-recipient text characteristics and health outcomes, the frequency and type of text messaging with caregivers was significantly associated with changes in health outcomes. Conclusions: This study represents the most extensive evaluation of diabetes-related SMS use and health outcomes for NICH participants to date. Findings demonstrate improvements in patient health during NICH program involvement. Implications include that sending frequent, personalized, and adherence-reinforcing texts to patients' caregivers may result in improved patient health, decreased utilization, and, potentially, associated reductions in health care costs.
KW - NICH
KW - SMS
KW - adolescence
KW - mHealth
KW - text message
KW - type 1 diabetes
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U2 - 10.1177/1932296817695337
DO - 10.1177/1932296817695337
M3 - Article
C2 - 28745094
AN - SCOPUS:85018940698
SN - 1932-2968
VL - 11
SP - 468
EP - 475
JO - Journal of Diabetes Science and Technology
JF - Journal of Diabetes Science and Technology
IS - 3
ER -