JMIR Diabetes最新文献

{"title":"Exploring the Needs and Preferences of Users and Parents to Design a Mobile App to Deliver Mental Health Peer Support to Adolescents With Type 1 Diabetes: Qualitative Study.","authors":"Titilola I Yakubu, Poonamdeep Jhajj, Samantha Pawer, Nicholas C West, Shazhan Amed, Tricia S Tang, Matthias Görges","doi":"10.2196/64267","DOIUrl":"https://doi.org/10.2196/64267","url":null,"abstract":"<p><strong>Background: </strong>Beyond physical health, managing type 1 diabetes (T1D) also encompasses a psychological component, including diabetes distress, that is, the worries, fears, and frustrations associated with meeting self-care demands over the lifetime. While digital health solutions have been increasingly used to address emotional health in diabetes, these technologies may not uniformly meet the unique concerns and technological savvy across all age groups.</p><p><strong>Objective: </strong>This study aimed to explore the mental health needs of adolescents with T1D, determine their preferred modalities for app-based mental health support, and identify desirable design features for peer-delivered mental health support modeled on an app designed for adults with T1D.</p><p><strong>Methods: </strong>A semistructured qualitative focus group study was conducted with adolescents with T1D and parents of adolescents with T1D. Data were collected through pre-focus group surveys, including sociodemographic background, diabetes status, health care experiences, and focus group sessions, including their opinions on peer support and technology. A thematic analysis following an inductive and iterative process was performed to develop themes and subthemes from the collected information.</p><p><strong>Results: </strong>Focus group participants included 10 adolescents (mean 16, SD 1 years; 8/10, 80% female; who had been living with diabetes for an average of 9, SD 5 years) and 10 parents (mean age 51, SD 7 years; 9/10, 90% female). Four core themes emerged: (1) experience: navigating adolescence with T1D, (2) empowerment: support systems that enabled better management of their T1D, (3) obstacles: societal barriers that affect adolescents' T1D management, and (4) innovation: adolescent-driven preferences for digital peer support platforms.</p><p><strong>Conclusions: </strong>App-based peer support offers a promising avenue for addressing the mental health needs of adolescents with T1D. Understanding the unique support needs of these adolescents and using this information to suggest design considerations for a mental health peer support app is an important step toward addressing their complex emotional and social challenges.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e64267"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Now I can see it works!\" Perspectives on Using a Nutrition-Focused Approach When Initiating Continuous Glucose Monitoring in People with Type 2 Diabetes: Qualitative Interview Study.","authors":"Holly J Willis, Maren S G Henderson, Laura J Zibley, Meghan M JaKa","doi":"10.2196/67636","DOIUrl":"https://doi.org/10.2196/67636","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Food choices play a significant role in achieving glycemic goals and optimizing overall health for people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) can provide a comprehensive look at the impact of foods and other behaviors on glucose in real time and over the course of time. The impact of using a nutrition-focused approach (NFA) when initiating CGM in people with T2D is unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to understand the perspectives and behaviors of people with T2D who participated in an NFA during CGM initiation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Semistructured qualitative interviews were conducted with UNITE (Using Nutrition to Improve Time in Range) study participants. UNITE was a 2-session intervention designed to introduce and initiate CGM using an NFA in people with T2D who do not use insulin. The intervention included CGM initiation materials that emphasized the continuous glucose monitor as a tool to guide evidence-based food choices. The materials were designed to support conversation between the CGM user and diabetes care provider conducting the sessions. A rapid matrix analysis approach was designed to answer two main questions: (1) How do people who participate in an NFA during CGM initiation describe this experience? and (2) How do people who participate in an NFA during CGM initiation use CGM data to make food-related decisions, and what food-related changes do they make?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 15 people completed interviews after completion of the UNITE study intervention: 87% (n=13) identified as White, 60% (n=9) identified as male, mean age of 64 (SD 7.4) years, mean T2D duration of 7.5 (SD 3.8) years, and mean hemoglobin A&lt;sub&gt;1c&lt;/sub&gt; level of 7.5% (SD 0.4%). Participants fluently discussed glycemic metrics such as time in range (percent time with glucose 70-180 mg/dL) and reported regularly using real-time and retrospective CGM data. Participants liked the simplicity of the intervention materials (eg, images and messaging), which demonstrated how to use CGM data to learn the glycemic impact of food choices and suggested how to adjust food choices for improved glycemia. Participants reported that CGM data impacted how they thought about food, and most participants made changes because of seeing these data. Many of the reported changes aligned with evidence-based guidance for a healthy lifestyle, including prioritizing nonstarchy vegetables, reducing foods with added sugar, or walking more; however, some people reported behavior changes, such as skipping or delaying meals to stay in the target glucose range. A few participants reported that the CGM amplified negative feelings about food or eating.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Participants agreed that pairing nutrition information with CGM initiation instructions was helpful for their diabetes care. In general, the NFA during CGM initiation was well received and led to positive","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e67636"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Personalized Digital Experiences to Promote Diabetes Self-Management: Mixed Methods Social Computing Approach.","authors":"Tavleen Singh, Kirk Roberts, Kayo Fujimoto, Jing Wang, Constance Johnson, Sahiti Myneni","doi":"10.2196/60109","DOIUrl":"10.2196/60109","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes affects nearly 34.2 million adults and is the seventh leading cause of death in the United States. Digital health communities have emerged as avenues to provide social support to individuals engaging in diabetes self-management (DSM). The analysis of digital peer interactions and social connections can improve our understanding of the factors underlying behavior change, which can inform the development of personalized DSM interventions.</p><p><strong>Objective: </strong>Our objective is to apply our methodology using a mixed methods approach to (1) characterize the role of context-specific social influence patterns in DSM and (2) derive interventional targets that enhance individual engagement in DSM.</p><p><strong>Methods: </strong>Using the peer messages from the American Diabetes Association support community for DSM (n=~73,000 peer interactions from 2014 to 2021), (1) a labeled set of peer interactions was generated (n=1501 for the American Diabetes Association) through manual annotation, (2) deep learning models were used to scale the qualitative codes to the entire datasets, (3) the validated model was applied to perform a retrospective analysis, and (4) social network analysis techniques were used to portray large-scale patterns and relationships among the communication dimensions (content and context) embedded in peer interactions.</p><p><strong>Results: </strong>The affiliation exposure model showed that exposure to community users through sharing interactive communication style speech acts had a positive association with the engagement of community users. Our results also suggest that pre-existing users with type 2 diabetes were more likely to stay engaged in the community when they expressed patient-reported outcomes and progress themes (communication content) using interactive communication style speech acts (communication context). It indicates the potential for targeted social network interventions in the form of structural changes based on the user's context and content exchanges with peers, which can exert social influence to modify user engagement behaviors.</p><p><strong>Conclusions: </strong>In this study, we characterize the role of social influence in DSM as observed in large-scale social media datasets. Implications for multicomponent digital interventions are discussed.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e60109"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Use of Activity Trackers to Support Physical Activity and Reduce Sedentary Behavior in Adults Diagnosed With Type 2 Diabetes: Qualitative Interview Study Using the RE-AIM Framework.","authors":"William Hodgson, Alison Kirk, Marilyn Lennon, Xanne Janssen","doi":"10.2196/60066","DOIUrl":"https://doi.org/10.2196/60066","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of type 2 diabetes in adults worldwide is increasing. Low levels of physical activity and sedentary behavior are major risk factors for developing the disease. Physical activity interventions incorporating activity trackers can reduce blood glucose levels in adults diagnosed with type 2 diabetes. The My Diabetes My Way website is a support and educational platform for people diagnosed with diabetes and health care professionals. Users of the My Diabetes My Way website can upload their Fitbit (Google Inc) activity data into the system but this is not presently being analyzed and used routinely within clinical care. Developers of the My Diabetes My Way system are planning to allow different makes of activity trackers to be integrated with the platform.</p><p><strong>Objective: </strong>This qualitative study aimed to explore (through the RE-AIM [reach, effectiveness, adoption, implementation, and maintenance] framework) views from adults diagnosed with type 2 diabetes and health care professionals on the integration of activity trackers into type 2 diabetes care.</p><p><strong>Methods: </strong>Overall, 12 adults diagnosed with type 2 diabetes and 9 health care professionals (4 general practitioners, 1 consultant, 2 diabetes nurses, 1 practice nurse, and 1 physical activity advisor) were recruited through social media and professional contacts. Semistructured one-to-one interviews were conducted. Abductive thematic analysis was undertaken, and main themes and subthemes were identified. The RE-AIM framework was used to evaluate the themes with respect to the wider use of activity trackers and the My Diabetes My Way platform within type 2 diabetes clinical care.</p><p><strong>Results: </strong>Overall, 6 main themes (awareness, access, cost, promotion, support, and technology and data) and 20 subthemes were identified. Evaluation using the 5 RE-AIM dimensions found that reach could be improved by raising awareness of the My Diabetes My Way platform and the ability to upload activity tracker data into the system. Effectiveness could be improved by implementing appropriate personalized measures of health benefits and providing appropriate support for patients and health care staff. Adoption could be improved by better promotion of the intervention among stakeholders and the development of joint procedures. Implementation could be improved through the development of an agreed protocol, staff training, and introducing measurements of costs. Maintenance could be improved by supporting all patients for long-term engagement and measuring improvements to patients' health.</p><p><strong>Conclusions: </strong>Through this study, we identified how the reach, effectiveness, adoption, implementation, and maintenance of integrating activity trackers into adult type 2 diabetes care could be improved.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e60066"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Opportunities and Challenges for the Spread, Scale-Up, and Sustainability of mHealth Apps for Self-Management of Patients With Type 2 Diabetes Mellitus in the Netherlands: Citizen Science Approach.","authors":"Catharina Margaretha van Leersum, Marloes Bults, Egbert Siebrand, Theodorus Johannes Josef Olthuis, Robin Enya Marije Bekhuis, Annemieke Ariënne Johanneke Konijnendijk, Marjolein Elisabeth Maria den Ouden","doi":"10.2196/56917","DOIUrl":"10.2196/56917","url":null,"abstract":"<p><strong>Background: </strong>Technologies evolve at a breakneck pace, and the success of mobile health (mHealth) for people with type 2 diabetes mellitus (T2DM) depends on whether health care professionals, care management, government regulators, and consumers will adopt the technology as a viable solution to enhance patient self-management.</p><p><strong>Objective: </strong>In this study, we explored the challenges of the implementation of mHealth apps in care for patients with T2DM and determined to what extent these challenges complicate the dissemination, limit scale-up, and influence the sustainability of technological interventions for patients with T2DM.</p><p><strong>Methods: </strong>The nonadoption, abandonment, and challenges to scale-up, spread, and sustainability (NASSS) framework served as the basis for our study. The 7 domains of the NASSS framework were explored with a citizen science approach using questionnaires, semistructured in-depth interviews, and focus groups together with patients with T2DM, care professionals, technology developers, policy officers, and a patient organization.</p><p><strong>Results: </strong>Regarding the domain \"condition,\" being aware of their condition and changing lifestyle were crucial for patients with T2DM to get to grips with their life. The rapid development of health apps for T2DM was highlighted in the domain \"technology.\" Users should be aware of these apps and know how to use them. The domain \"value proposition\" included the patient perspective and elaborated on personal values, as well as care professionals who focus on personalized care and pressure on health care. Regarding the \"adopters,\" it is crucial to know who needs to use and introduce the apps. Responsibility, a shared vision, and resistance among care professionals were mentioned as important determinants for \"organization.\" Finally, the domain \"wider system\" showed the importance of involving multiple institutes, care guidelines, and reimbursements.</p><p><strong>Conclusions: </strong>This study investigated the implementation of mHealth apps in an early stage of the implementation process. Key stakeholders were involved, who attributed to the possibilities and limitations of the implementation. It is crucial to have a clear vision from an organizational perspective and specific prerequisites for implementation strategies at micro, meso, and macro levels. Essential strategies at the national level include guidelines for regulations, privacy, and security; the integration of mHealth into T2DM care guidelines; and sufficient reimbursement by health insurers.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e56917"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized and Culturally Tailored Features of Mobile Apps for Gestational Diabetes Mellitus and Their Impact on Patient Self-Management: Scoping Review.","authors":"Catherine Jones, Yi Cui, Ruth Jeminiwa, Elina Bajracharya, Katie Chang, Tony Ma","doi":"10.2196/58327","DOIUrl":"10.2196/58327","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is an increasingly common high-risk pregnancy condition requiring intensive daily self-management, placing the burden of care directly on the patient. Understanding personal and cultural differences among patients is critical for delivering optimal support for GDM self-management, particularly in high-risk populations. Although mobile apps for GDM self-management are being used, limited research has been done on the personalized and culturally tailored features of these apps and their impact on patient self-management.</p><p><strong>Objective: </strong>This scoping review aims to explore the extent to which published studies report the integration and effectiveness of personalized and culturally tailored features in GDM mobile apps for patient self-management support.</p><p><strong>Methods: </strong>We examined English-language peer-reviewed articles published between October 2016 and May 2023 from PubMed, CINAHL, PsycINFO, ClinicalTrials.gov, Proquest Research Library, and Google Scholar using search terms related to digital tools, diabetes, pregnancy, and cultural tailoring. We reviewed eligible articles and extracted data using the Arskey and O'Malley methodological framework.</p><p><strong>Results: </strong>Our search yielded a total of 1772 articles after the removal of duplicates and 158 articles for full-text review. A total of 21 articles that researched 15 GDM mobile apps were selected for data extraction. Our results demonstrated the stark contrast between the number of GDM mobile apps with personalized features for the individual user (all 15 mobile apps) and those culturally tailored for a specific population (only 3 of the 15 mobile apps). Our findings showed that GDM mobile apps with personalized and culturally tailored features were perceived to be useful to patients and had the potential to improve patients' adherence to glycemic control and nutrition plans.</p><p><strong>Conclusions: </strong>There is a strong need for increased research and development to foster the implementation of personalized and culturally tailored features in GDM mobile apps for self-management that cater to patients from diverse backgrounds and ethnicities. Personalized and culturally tailored features have the potential to serve the unique needs of patients more efficiently and effectively than generic features alone; however, the impacts of such features still need to be adequately studied. Recommendations for future research include examining the cultural needs of different ethnicities within the increasingly diverse US population in the context of GDM self-management, conducting participatory-based research with these groups, and designing human-centered mobile health solutions for both patients and providers.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e58327"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Blood Glucose Data With Physiological and Nutritional Data From Dietary Surveys and Wearable Devices: Database Analysis.","authors":"Takashi Miyakoshi, Yoichi M Ito","doi":"10.2196/62831","DOIUrl":"10.2196/62831","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Wearable devices can simultaneously collect data on multiple items in real time and are used for disease detection, prediction, diagnosis, and treatment decision-making. Several factors, such as diet and exercise, influence blood glucose levels; however, the relationship between blood glucose and these factors has yet to be evaluated in real practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to investigate the association of blood glucose data with various physiological index and nutritional values using wearable devices and dietary survey data from PhysioNet, a public database.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Three analytical methods were used. First, the correlation of each physiological index was calculated and examined to determine whether their mean values or SDs affected the mean value or SD of blood glucose. To investigate the impact of each physiological indicator on blood glucose before and after the time of collection of blood glucose data, lag data were collected, and the correlation coefficient between blood glucose and each physiological indicator was calculated for each physiological index. Second, to examine the relationship between postprandial blood glucose rise and fall and physiological and dietary nutritional assessment indices, multiple regression analysis was performed on the relationship between the slope before and after the peak in postprandial glucose over time and physiological and dietary nutritional indices. Finally, as a supplementary analysis to the multiple regression analysis, a 1-way ANOVA was performed to compare the relationship between the upward and downward slopes of blood glucose and the groups above and below the median for each indicator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The analysis revealed several indicators of interest: First, the correlation analysis of blood glucose and physiological indices indicated meaningful relationships: acceleration SD (r=-0.190 for lag data at -15-minute values), heart rate SD (r=-0.121 for lag data at -15-minute values), skin temperature SD (r=-0.121), and electrodermal activity SD (r=-0.237) for lag data at -15-minute values. Second, in multiple regression analysis, physiological indices (temperature mean: t=2.52, P=.01; acceleration SD: t=-2.06, P=.04; heart rate_30 SD: t=-2.12, P=.04; electrodermal activity_90 SD: t=1.97, P=.049) and nutritional indices (mean carbohydrate: t=6.53, P&lt;.001; mean dietary fiber: t=-2.51, P=.01; mean sugar: t=-3.72, P&lt;.001) were significant predictors. Finally, the results of the 1-way ANOVA corroborated the findings from the multiple regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Similar results were obtained from the 3 analyses, consistent with previous findings, and the relationship between blood glucose, diet, and physiological indices in the real world was examined. Data sharing facilitates the accessibility of wearable data and enables statistical analyses from various angles. This type ","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e62831"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and eHealth Literacy of Patients With Diabetes in Low-Income Countries: Perspective From Guinea and Burkina Faso.","authors":"Ismaila Ouedraogo, Borlli Michel J Some, Roland Benedikter, Gayo Diallo","doi":"10.2196/55677","DOIUrl":"10.2196/55677","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a significant health concern in sub-Saharan Africa, emphasizing the importance of assessing the health literacy and eHealth skills of hospitalized patients with diabetes. This study evaluated the health literacy and eHealth literacy of patients with diabetes at Donka Hospital in Guinea and Sanou Sourou Hospital in Burkina Faso, providing insights for targeted interventions and mobile health (mHealth) solutions to improve self-management and treatment outcomes.</p><p><strong>Objective: </strong>The aim of this study is to evaluate the levels of health literacy and eHealth literacy among patients at Sanou Sourou Hospital in Burkina Faso and Donka Hospital in Guinea.</p><p><strong>Methods: </strong>The study included 45 participants from Donka Hospital and 47 from Sanou Sourou Hospital. Data collection took place in May 2022, focusing on variables such as gender, age, education, income, and technology access. Health literacy and eHealth literacy were measured using the Brief Health Literacy Screen (BHLS) and the eHealth Literacy Scale (eHEALS), respectively. Statistical analysis was performed using SPSS 28.</p><p><strong>Results: </strong>The results indicated that 64% (64/99) of participants at Donka Hospital and 57% (57/99) at Sanou Sourou Hospital were female. The majority of participants (48/98, 49% in both hospitals) fell within the age range of 25-50 years. High rates of illiteracy were observed (62/100, 62% in Donka Hospital and 59/100, 59% in Sanou Sourou Hospital). Smartphone ownership was prevalent (62/99, 62% at Donka Hospital and 64/100, 64% at Sanou Sourou Hospital). Participants reported occasional use of technology for basic purposes and frequent internet usage for accessing health information. However, a significant proportion of participants demonstrated low health literacy (73/99, 73% at Donka Hospital; 79/101, 78% at Sanou Sourou Hospital) and inadequate eHealth literacy (57/100, 57% at Donka Hospital; 62/100, 62% at Sanou Sourou Hospital). Education was observed to positively correlate with health literacy, while age displayed a moderate negative correlation. Weak correlations were observed between gender, income, and health literacy, but these were not statistically significant. No significant correlation was found between the scores of the BHLS and the eHEALS in either hospital.</p><p><strong>Conclusions: </strong>This study highlights the importance of targeted educational interventions and mHealth solutions aimed at enhancing health and eHealth literacy among hospitalized patients with diabetes. Addressing both health literacy and eHealth literacy is paramount for improving diabetes management and treatment outcomes in Guinea and Burkina Faso. Targeted interventions and mHealth solutions have the potential to empower patients, enabling their active involvement in health care decisions and ultimately improving overall health outcomes.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e55677"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Text Messaging Intervention as an In-Between Support to Diabetes Group Visits in Federally Qualified Health Centers: Cluster Randomized Controlled Study.","authors":"Allie Z Yan, Erin M Staab, Daisy Nuñez, Mengqi Zhu, Wen Wan, Cynthia T Schaefer, Amanda Campbell, Michael T Quinn, Arshiya A Baig","doi":"10.2196/55473","DOIUrl":"10.2196/55473","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the United States, 1 in 11 people receive primary care from a federally qualified health center (FQHC). Text messaging interventions (TMIs) are accessible ways to deliver health information, engage patients, and improve health outcomes in the health center setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate the impact of a TMI implemented with a group visit (GV) intervention among patients with type 2 diabetes mellitus (T2DM) at FQHCs on patient-reported outcomes and clinical outcomes based on patient TMI engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A TMI was implemented for 11 health centers participating in a cluster randomized study of diabetes GVs in Midwestern FQHCs targeting adults with T2DM. FQHC patients participated in 6 monthly GVs either in person or online and a concurrent 25-week TMI. Outcome measures included clinical markers such as glycated hemoglobin A1c and patient-reported diabetes distress, diabetes self-care, diabetes self-efficacy, diabetes care knowledge, diabetes quality of life, diabetes social support, and TMI use and satisfaction. TMI response rate was calculated as responses to an SMS text message requesting a response divided by total messages requesting a response sent. Patients were grouped as high responders if their response rate was greater than or equal to the median response rate and low responders if their response rate was below the median. We conducted linear mixed models to compare high and low responders and within a group, adjusting for age, gender, GV attendance, and depression/anxiety at baseline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 101 of 124 GV patients (81.5%) enrolled in the TMI. The average age of the population in the TMI was 53 years. Of the 101 respondents, 61 (60%) were racial or ethnic minorities, while 42 of 82 respondents (51%) had a high school diploma/General Education Development or less, and 56 of 80 respondents (71%) reported an annual income less than US $30,000. In addition, 70 of 81 respondents (86%) owned a smartphone and 74 of 80 respondents (93%) had an unlimited texting plan. The median response rate was 41% and the mean response rate was 41.6%. Adjusted models showed significantly improved diabetes knowledge (P&lt;.001), foot care (P&lt;.001), and exercise (P=.002) in high responders (n=34) compared to low responders (n=23) at 6 months. No group difference was found in glycated hemoglobin A1c. Within high responders, diabetes distress (P=.001), social support (P&lt;.001), quality of life (P&lt;.001), diabetes knowledge (P&lt;.001), foot care (P&lt;.001), and diet (P=.003) improved from baseline to 6 months. Low responders only improved in diabetes quality of life (P=.003) from baseline to 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In a FQHC safety net population participating in a combined TMI and GV intervention, our study showed improved diabetes distress, social support, knowledge, self-care, self-efficacy, and quality of life among patien","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e55473"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four New Patient-Reported Outcome Measures Examining Health-Seeking Behavior in Persons With Type 2 Diabetes Mellitus (REDD-CAT): Instrument Development Study.","authors":"Suzanne E Mitchell, Michael A Kallen, Jonathan P Troost, Barbara A De La Cruz, Alexa Bragg, Jessica Martin-Howard, Ioana Moldovan, Jennifer A Miner, Brian W Jack, Noelle E Carlozzi","doi":"10.2196/63434","DOIUrl":"10.2196/63434","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The management of type 2 diabetes mellitus (T2DM) includes mastery of complex care activities, self-management skills, and routine health care encounters to optimize glucose control and achieve good health. Given the lifelong course of T2DM, patients are faced with navigating complex medical and disease-specific information. This health-seeking behavior is a driver of health disparities and is associated with hospitalization and readmission. Given that health-seeking behavior is a potentially intervenable social determinant of health, a better understanding of how people navigate these complex systems is warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To address this need, we aimed to develop new patient-reported outcome (PRO) measures that evaluate health-seeking behavior in persons with T2DM. These new PROs were designed to be included in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system, which includes several other PROs that capture the importance of social determinants of health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Overall, 225 participants with T2DM completed 56 self-report items that examined health-seeking behaviors. Classical Test Theory and Item Response Theory were used for measurement development. Exploratory factor analysis (EFA; criterion ratio of eigenvalue 1 to eigenvalue 2 being &gt;4; variance for eigenvalue 1 ≥40%) and confirmatory factor analysis (CFA; criterion 1-factor CFA loading &lt;.50; 1-factor CFA residual correlation &gt;.20; comparative fit index ≥0.90; Tucker-Lewis index ≥0.90; root mean square error of approximation &lt;0.15) were used to determine unidimensional sets of items. Items with sparse responses, low-adjusted total score correlations, nonmonotonicity, low factor loading, and high residual correlations of high error modification indices were candidates for exclusion. A constrained graded response model was used to examine item misfit, and differential item functioning was examined to identify item bias. Cronbach α was used to examine internal consistency reliability for the new PROs (criterion ≥0.70), and floor and ceiling effects were examined (criterion ≤20%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four unidimensional sets of items were supported by EFA (all EFA eigenvalue ratios &gt;4; variance for eigenvalue 1=41.4%-67.3%) and CFA (fit statistics all exceeded criterion values). This included (1) \"Health-Seeking Behavior: PCP-Specific\" (6 items); (2) \"Health-Seeking Behavior: General Beliefs\" (13 items); (3) \"Health-Seeking Behavior: Family or Friends-Specific\" (5 items); and (4) \"Health-Seeking Behavior: Internet-Specific\" (4 items). All items were devoid of differential item functioning for age, sex, education, or socioeconomic status factors. \"Health-Seeking Behavior: General Beliefs\" was developed to include both a computer adaptive test and a 6-item short form version; all other PROs were developed as static short forms. The psychometric reliability of ","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"9 ","pages":"e63434"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}