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Brown SA, Winter MA, Becker HA, García AA, Velasquez MM, Tanaka H, Perkison WB, Brown EL, Aguilar D, Hanis CL. Transitioning From an In-Person Intervention to Augmented Text Messaging During COVID-19 in Mexican Americans With Prediabetes: The Starr County Diabetes Prevention Randomized Clinical Trial. Sci Diabetes Self Manag Care 2024; 50:107-115. [PMID: 38454633 PMCID: PMC11062239 DOI: 10.1177/26350106241233475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
PURPOSE The purpose of the study was to explore the feasibility of using commonly available technology, such as text messaging, for diabetes prevention in rural Mexican American communities during COVID-19. METHODS Participants were selected from a diabetes prevention study funded by the National Institutes of Health that, prior to COVID-19, involved in-person group intervention sessions. Participants were predominantly female adults born in Mexico and Spanish-speaking. A subsample (n = 140) was divided into 3 cohorts: (1) 50 who completed the initial in-person intervention prior to the COVID-19 research pause, (2) 60 who needed additional support sessions to complete the intervention and thus received 10 text messages with links to relevant online diabetes prevention videos (TM+), and (3) 30 who received enhanced usual care involving health guidance offered during data collection (control). Repeated measures analysis of covariance was used to evaluate cohort differences at 24 months post baseline. RESULTS No significant cohort differences were found for depression, eating self-efficacy, alcohol intake, fat avoidance, or sedentary behaviors. Differences in A1C showed both in-person and TM+ cohorts having lower mean A1C levels (5.5%) than the control cohort (5.7%). The TM+ cohort had lower body mass index than other cohorts and a lower diabetes conversion rate (22.2%) compared to the control cohort (28%). Participants indicated preferences for in-person/TM+ combination interventions. The strongest positive feedback was for the TM+ intervention cooking demonstration videos. CONCLUSIONS Augmented text messaging combined with in-person sessions had similar outcomes to the all in-person strategy and thus has the potential for expanding the reach of diabetes prevention to many Mexican American communities.
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Affiliation(s)
- Sharon A. Brown
- The University of Texas at Austin School of Nursing, Austin, Texas
| | - Mary A. Winter
- The University of Texas at Austin School of Nursing, Austin, Texas
| | | | | | - Mary M. Velasquez
- The University of Texas at Austin School of Social Work, Austin, Texas
| | - Hirofumi Tanaka
- The University of Texas at Austin Department of Kinesiology & Health Education, Austin, Texas
| | - William B. Perkison
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, Texas
| | - Eric L. Brown
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, Texas
| | - David Aguilar
- LSU Health New Orleans School of Medicine, Division of Cardiovascular Medicine, New Orleans, Louisiana
| | - Craig L. Hanis
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, Texas
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Shaban MM, Sharaa HM, Amer FGM, Shaban M. Effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of adult clients with diabetes. BMC Nurs 2024; 23:130. [PMID: 38378505 PMCID: PMC10877800 DOI: 10.1186/s12912-024-01787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND In recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes. METHODS Employing a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods. RESULTS The digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors. CONCLUSION This study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study's conclusions.
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Affiliation(s)
- Marwa Mamdouh Shaban
- Lecturer of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt.
| | - Heba Magdy Sharaa
- Professor of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
| | | | - Mostafa Shaban
- Lecturer of Geriatric Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
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L’Engle K, Trejo E, Landeros A, Zúñiga Sandoval E, Jauregui J, Yang S. Brief peer coaching complements daily digital messages for chronic disease prevention among young adult Latinas. Transl Behav Med 2024; 14:80-88. [PMID: 37339885 PMCID: PMC10849174 DOI: 10.1093/tbm/ibad036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
Young Latinas face multiple health challenges that place them at high risk for chronic diseases. Digital health promotion interventions can offer education and support to activate self-care and preventive behaviors. This pilot study evaluated a brief, theory-informed, culturally tailored intervention, Examen Tu Salud, that provided daily text and multimedia messages and weekly peer coaching via videoconference to improve health behaviors among young adult Latina women. Thirty-four participants who self-identified as Latina, female, and 18-29 years old were recruited from an urban college in Northern California to participate in a brief pilot test of the new intervention. Paired sample T-tests assessed health behavior and health activation changes from baseline to 1 month follow-up. Program participation and satisfaction were analyzed to assess feasibility of the intervention. Among 31 participants (91% completion), there were medium to large improvements in health outcomes. Confidence in preventing and managing one's health (t[30] = 5.18, p < .001, d = 0.93), days of moderate-intensity physical activity (t[30] = 3.50, p < .001, d = 0.63), and fruit (t[30] = 3.32, p = .001, d = 0.60) and vegetable (t[30] = 2.04, p = .025, d = 0.37) consumption in a typical day increased. Intervention satisfaction and engagement with health coaches was high. We found that a brief digital coaching intervention designed for young adult Latinas has the potential to improve health activation and behaviors. More attention is needed to prevent chronic conditions among a growing number of Latinos in the USA.
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Affiliation(s)
- Kelly L’Engle
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Evelin Trejo
- Department of Hematology Oncology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA
| | - Adam Landeros
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Erika Zúñiga Sandoval
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Jazmin Jauregui
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Susan Yang
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
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Spierling Bagsic SR, Savin KL, Soriano EC, San Diego ERN, Orendain N, Clark T, Sandoval H, Chichmarenko M, Perez-Ramirez P, Farcas E, Godino J, Gallo LC, Philis-Tsimikas A, Fortmann AL. Process evaluation of Dulce Digital-Me: an adaptive mobile health (mHealth) intervention for underserved Hispanics with diabetes. Transl Behav Med 2023; 13:635-644. [PMID: 37011033 PMCID: PMC10496430 DOI: 10.1093/tbm/ibad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Type 2 diabetes disproportionately impacts ethnic minorities and individuals from low socioeconomic status. Diabetes self-management education and support has been shown to improve clinical outcomes in these populations, and mobile health (mHealth) interventions can reduce barriers to access. Dulce Digital-Me (DD-Me) was developed to integrate adaptive mHealth technologies to enhance self-management and reduce disparities in the high-risk, underserved Hispanic population. The objective of the present study was to evaluate reach, adoption, and implementation of an mHealth diabetes self-management education and support intervention in this underrepresented population. The present analysis is a multimethod process evaluation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The study was effective in reaching a sample that was representative of the intended population; only modest but significant differences were observed in sex and age. The DD-Me health coach (HC) cited several important facilitators of intervention adoption, including outreach frequency and personalization, and the automated HC report. Implementation fidelity was high, with participants receiving >90% of intended interventions. Participants who received DD-Me with support from a HC were most engaged, suggesting utility and acceptability of integrating HCs with mHealth interventions. Perceptions of implementation among study participants were positive and consistent across study arms. This evaluation revealed the target population was successfully reached and engaged in the digital health interventions, which was implemented with high fidelity. Further studies should evaluate the efficacy and maintenance of the study following the RE-AIM model to determine whether this intervention warrants expansion to additional settings and populations.
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Affiliation(s)
| | - Kimberly L Savin
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Emily C Soriano
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA
| | | | - Natalia Orendain
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA
| | - Taylor Clark
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Haley Sandoval
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA
| | | | - Perla Perez-Ramirez
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Emilia Farcas
- Qualcomm Institute, University of California San Diego, La Jolla, CA, USA
| | - Job Godino
- Qualcomm Institute, University of California San Diego, La Jolla, CA, USA
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, CA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Addie L Fortmann
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA
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Rodriguez JA, Seiglie JA, Caballero AE. What Does a New Health Technology Landscape Mean for Hispanic/Latino People With Diabetes? Clin Diabetes 2023; 41:289-291. [PMID: 37092153 PMCID: PMC10115760 DOI: 10.2337/cd22-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Jorge A. Rodriguez
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Jacqueline Anne Seiglie
- Harvard Medical School, Boston, MA
- Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Augusto Enrique Caballero
- Harvard Medical School, Boston, MA
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Boston, MA
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