NICH at Its Best for Diabetes at Its Worst: Texting Teens and Their Caregivers for Better Outcomes

David V. Wagner, Samantha A. Barry, Maggie Stoeckel, Lena Teplitsky, Michael A. Harris

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)468-475
Number of pages8
JournalJournal of Diabetes Science and Technology
Volume11
Issue number3
DOIs
StatePublished - May 1 2017

Keywords

  • NICH
  • SMS
  • adolescence
  • mHealth
  • text message
  • type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Biomedical Engineering

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