A user centered design approach for patient interfaces to a diabetes IT platform

A Video Game for Brazilian T1D Children about Knowledge of Disease and Self-care: A Methodological Study

BACKGROUND

Video games are interactive technologies able to support children in health promotion, behavior changes, and chronic disease self-management. The use of health behavior change determinants in video game design can increase its effectiveness. This study describes the process of designing a video game for Brazilian children with T1D clarifying the use of health behavior change determinants that may influence self-management behaviors.

METHODS

This was a methodological study based on health behavior change theories and the user-centered design approach. The results of a qualitative study conducted with children aged 7 to 12 years identified learning needs about knowledge on diabetes and self-care tasks which contribute to inappropriate behaviors. A Behavioral Diagnosis presented health behavior change determinants, capable of influencing children's learning needs and behaviors, that were considered to design The Heroes of Diabetes-the power of knowledge.

RESULTS

The results presented the process of designing 4 mini games with its description and theory foundation to reach children's lack of understanding about T1D, insulin's role, SMBG requirements, food groups and physical activity's role in glycemic control. Knowledge, goal settings, extrinsic and intrinsic motivation determinants were related with video games design features.

CONCLUSIONS

The findings support the use of health behavior change determinants into video game design as a guide to achieve children learning needs and that might influence self-management behaviors.

Conceptual framework for designing video games for children with type 1 diabetes

OBJECTIVE

to present a theoretically based conceptual framework for designing video games for children with type 1 diabetes mellitus.

METHODS

this was a methodological study that developed a conceptual framework with nine steps in view of health behavior change theories and the user-centered design approach as theoretical and methodological frameworks, respectively. Twenty-one children, aged 7 to 12 years, participated by expressing their needs and preferences related to diabetes and video games. Data were analysed following content analysis guidelines. Then, a choice of appropriate health behavioral change theories and their determinants that should be capable of influencing children's behaviors and preferences.

RESULTS

the conceptual framework proposes a video game that consists of six phases, each addressing one stage of behavioral change and specific determinants, aligned with the needs and preferences identified by the participating children. This study shows the applicability of this framework in view of each proposed phase presenting examples and the children's ideas.

CONCLUSION

the results of this study contribute to advance the discussion on how behavioral theories and their determinants should be related to the design of creative and funny video games considering the profile of the target population as well as its needs and preferences.

Radio-Frequency and Microwave Techniques for Non-Invasive Measurement of Blood Glucose Levels

This paper reviews non-invasive blood glucose measurements via dielectric spectroscopy at microwave frequencies presented in the literature. The intent is to clarify the key challenges that must be overcome if this approach is to work, to suggest some possible ways towards addressing these challenges and to contribute towards prevention of unnecessary ‘reinvention of the wheel’.

Artificial Intelligence for Diabetes Management and Decision Support: Literature Review

Background

Artificial intelligence methods in combination with the latest technologies, including medical devices, mobile computing, and sensor technologies, have the potential to enable the creation and delivery of better management services to deal with chronic diseases. One of the most lethal and prevalent chronic diseases is diabetes mellitus, which is characterized by dysfunction of glucose homeostasis.

Objective

The objective of this paper is to review recent efforts to use artificial intelligence techniques to assist in the management of diabetes, along with the associated challenges.

Methods

A review of the literature was conducted using PubMed and related bibliographic resources. Analyses of the literature from 2010 to 2018 yielded 1849 pertinent articles, of which we selected 141 for detailed review.

Results

We propose a functional taxonomy for diabetes management and artificial intelligence. Additionally, a detailed analysis of each subject category was performed using related key outcomes. This approach revealed that the experiments and studies reviewed yielded encouraging results.

Conclusions

We obtained evidence of an acceleration of research activity aimed at developing artificial intelligence-powered tools for prediction and prevention of complications associated with diabetes. Our results indicate that artificial intelligence methods are being progressively established as suitable for use in clinical daily practice, as well as for the self-management of diabetes. Consequently, these methods provide powerful tools for improving patients’ quality of life.

The Value of Children's Voices for a Video Game Development in the Context of Type 1 Diabetes: Focus Group Study

BACKGROUND

Children with type 1 diabetes mellitus (T1DM) face daily challenges performing self-care tasks, controlling symptoms, and dealing with psychosocial issues. The use of video games to improve health is a successful support for persons with chronic diseases, promoting adequate self-management through simulations of real life. Involving future users in the development of games is essential to generating innovative, creative, and effective programs.

OBJECTIVE

Our goal is to identify what children with T1DM need to know about their disease and their self-care tasks as well as their preferences in video games.

METHODS

Children with T1DM provided input about their learning needs, self-care tasks, and preferences in video games. Three categories were identified through qualitative content analysis: dealing with emotions and knowledge, practical skills and awareness, and game preferences.

RESULTS

Children expressed concerns about the difficulties of self-care, lack of knowledge about diabetes, and lack of awareness about the consequences of behaviors related to self-care, which contribute to inappropriate behaviors and significantly impact self-management of their disease. They expressed enthusiasm for a video game for children with diabetes that considered their needs and preferences.

CONCLUSIONS

Findings support the potential benefits when children's input is considered in game design. Consideration of customer needs and preferences is a powerful resource in the development of video games with enhanced learning experience.

Use of an holistic approach for effective adoption of User-Centred-Design techniques in diabetes disease management: Experiences in user need elicitation

One of the most important challenges of designing eHealth tools for Chronic Disease Management is to understand how transforming cutting-edge innovations in something that can impact the current clinical practice and improve the performance of the health care systems. The adoption of User Centered Design techniques is fundamental in order to integrate these systems in an effective and successful way. The work presented in this paper describe the methodologies used in the context of two multidisciplinary research projects, METABO and MOSAIC. The adoption of the methodologies have been driven by the CeHRes Roamap, a holistic framework that support participatory development of eHealth. The work reported in this paper describes the results of the first two (out of the five) phases in eliciting user needs.

Performance assessment of a closed-loop system for diabetes management

Telemedicine systems can play an important role in the management of diabetes, a chronic condition that is increasing worldwide. Evaluations on the consistency of information across these systems and on their performance in a real situation are still missing. This paper presents a remote monitoring system for diabetes management based on physiological sensors, mobile technologies and patient/doctor applications over a service-oriented architecture that has been evaluated in an international trial (83,905 operation records). The proposed system integrates three types of running environments and data engines in a single service-oriented architecture. This feature is used to assess key performance indicators comparing them with other type of architectures. Data sustainability across the applications has been evaluated showing better outcomes for full integrated sensors. At the same time, runtime performance of clients has been assessed spotting no differences regarding the operative environment.

Integration of Personalized Healthcare Pathways in an ICT Platform for Diabetes Managements: A Small-Scale Exploratory Study

The availability of new tools able to support patient monitoring and personalized care may substantially improve the quality of chronic disease management. A personalized healthcare pathway (PHP) has been developed for diabetes disease management and integrated into an information and communication technology system to accomplish a shift from organization-centered care to patient-centered care. A small-scale exploratory study was conducted to test the platform. Preliminary results are presented that shed light on how the PHP influences system usage and performance outcomes.

Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries

Background

Self-management of long term conditions can promote quality of life whilst delivering benefits to the financing of health care systems. However, rarely are the meso-level influences, likely to be of direct relevance to these desired outcomes, systematically explored. No specific international guidelines exist suggesting the features of the most appropriate structure and organisation of health care systems within which to situate self-management approaches and practices. This review aimed to identify the quantitative literature with regard to diabetes self-management arrangements currently in place within the health care systems of six countries (The United Kingdom, The Netherlands, Norway, Spain, Bulgaria, and Greece) and explore how these are integrated into the broader health care and welfare systems in each country.

Methods

The methodology for a realist review was followed. Publications of interest dating from 2000 to 2013 were identified through appropriate MeSH terms by a systematic search in six bibliographic databases. A search diary was maintained and the studies were assessed for their quality and risk of bias.

Results

Following the multi-step search strategy, 56 studies were included in the final review (the majority from the UK) reporting design methods and findings on 21 interventions and programmes for diabetes and chronic disease self-management. Most (11/21, 52%) of the interventions were designed to fit within the context of primary care. The majority (11/21, 52%) highlighted behavioural change as an important goal. Finally, some (5/21, 24%) referred explicitly to Internet-based tools.

Conclusions

This review is based on results which are derived from a total of at least 5,500 individuals residing in the six participating countries. It indicates a policy shift towards patient-centred self-management of diabetes in a primary care context. The professional role of diabetes specialist nurses, the need for multidisciplinary approaches and a focus on patient education emerge as fundamental principles in the design of relevant programmes. Socio-economic circumstances are relevant to the capacity to self-manage and suggest that any gains and progress will be hard to maintain during economic austerity. This realist review should be interpreted within the wider context of a whole systems approach regarding self-care support and chronic illness management.

Electronic supplementary material

The online version of this article (doi:10.1186/1472-6963-14-453) contains supplementary material, which is available to authorized users.