Wednesday, February 20, 2013

Approaches to Managing Diabetes

A Wayne State University researcher received $36,000 in grants from the Southeastern Michigan Health Association and from Greater Cincinnati HealthBridge Inc. to help determine the success of a Type 2 diabetes intervention program called “txT4Health” currently being piloted in Southeast Michigan, greater Cincinnati, and New Orleans

The “txT4Health” program, a 14 week test message-based behavioral intervention targeting Type 2 diabetes, is a joint venture of the American Diabetes Association, CDC, ONC, Voxiva, and the Southeast Michigan Beacon Community, Greater Cincinnati Beacon Community, and Crescent City Beacon Community in New Orleans.

“Txt4health” delivers tailored messages to users based on their individual risk for developing Type 2 diabetes. The program includes several different approaches to promoting lifestyle and behavioral changes, including physical activity self-monitoring, weight goal setting, nutritional information, and motivational messaging.

In another research study, NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) supports research at Columbia University Medical Center, in their Department of Biomedical Informatics. The researchers are developing new decision-support tools to help facilitate problem solving in diabetes. The tool will use a combination of an interactive website and SMS messaging server.

Past research has shown that well developed problem solving abilities are essential to successful diabetes management and results in better diabetes self-care behaviors, which helps individuals improve their health. Health IT can help individuals develop the necessary problem solving abilities. Many health IT interventions target improved patient clinician communication along with improved monitoring, rather than focusing more specifically on fostering problem solving skills. 

This research is using the strategies used by diabetes educators to foster problem solving but the researchers will go one step further and develop a decision support tool called the Mobile Diabetes Detective (MoDD). This tool will help diabetics identify specific, personally significant challenges in diabetes management, generate alternative strategies for addressing these challenges, evaluate strategies through simple experiments, and be able to monitor outcomes.

A wizard-like interface on an interactive website will help individuals develop personal learning plans. SMS messages will be sent to people’s mobile phones to remind them of planned experiments and enable the individual to report the results.

MoDD will be built using an open source platform on chronic disease self-management developed by the research team and the team will then release the resulting tool to the research community. The effectiveness of MoDD will be evaluated in a randomized controlled trial and researchers will assess the tool’s potential public health impact using the RE-AIM framework.