1
|
Lyzwinski L, Menon C, Elgendi M. Conversational Agents for Improving Weight-Related Behaviors and Cardiometabolic Risk Factors: A Systematic Review (Preprint). JMIR Mhealth Uhealth 2022; 11:e39649. [DOI: 10.2196/39649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/04/2022] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
|
2
|
Eshtehardi SS, Hilliard ME. JPP Student Journal Club Commentary: Advancing Transition Medicine for Adolescents and Young Adults with Chronic Conditions. J Pediatr Psychol 2021; 46:12-14. [PMID: 33306795 DOI: 10.1093/jpepsy/jsaa109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sahar S Eshtehardi
- Department of Psychological, Health, & Learning Sciences, University of Houston
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital
| |
Collapse
|
3
|
Campbell MS, Wang J, Cheng Y, Cogen FR, Streisand R, Monaghan M. Diabetes-specific family conflict and responsibility among emerging adults with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:788-796. [PMID: 31021129 PMCID: PMC6776682 DOI: 10.1037/fam0000537] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Emerging adulthood is a transitional period for type 1 diabetes management, and aspects of family functioning such as family conflict and responsibility for diabetes management likely change following high school graduation. This study examined changes in diabetes-specific family conflict, family responsibility for diabetes management tasks, and associations with glycemic control up to 1 year after high school. Seventy-nine emerging adults with type 1 diabetes (M age = 18.09 ± .43 years; 51% female; 71% Caucasian) and their parents (73% female) completed self-report measures on diabetes-specific family conflict and family responsibility at 3 consecutive clinic visits, beginning in the spring of their senior year of high school. Hemoglobin A1c (HbA1c) was obtained from medical records. Diabetes-specific family conflict was relatively low; scores did not significantly change from baseline to Time 3. Parent responsibility for diabetes care decreased from baseline to Time 3. Higher parent- and emerging adult-reported family conflict and higher parent responsibility for diabetes care were associated with worse glycemic control (ps < .05). Parent-reported family conflict and the interaction between parent-reported family conflict and responsibility predicted HbA1c 1 year after high school. Conversely, HbA1c did not predict diabetes-specific family conflict or responsibility 1 year after high school. Findings indicate that diabetes-specific family conflict is associated with glycemic control after high school, even when emerging adults assume greater responsibility for diabetes self-care. Diabetes-specific family conflict levels were generally low and did not change over time despite this transitional period. If diabetes-specific conflict is present, it should be an important avenue for potential intervention for emerging adults with type 1 diabetes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Jichuan Wang
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Yao Cheng
- Children’s National Health System, Washington, DC
| | - Fran R. Cogen
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Randi Streisand
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Maureen Monaghan
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| |
Collapse
|
4
|
Thompson D, Callender C, Gonynor C, Cullen KW, Redondo MJ, Butler A, Anderson BJ. Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study. J Med Internet Res 2019; 21:e15318. [PMID: 31538940 PMCID: PMC6754689 DOI: 10.2196/15318] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 01/19/2023] Open
Abstract
Background Family conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions. Objective The purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent. Methods Parent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245). Results Twenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach. Conclusions The Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.5817
Collapse
Affiliation(s)
- Debbe Thompson
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Chishinga Callender
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Caroline Gonynor
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Karen W Cullen
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Maria J Redondo
- Diabetes and Endocrinology Section, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Ashley Butler
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Barbara J Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
5
|
Kabir MF, Schulman D, Abdullah AS. Promoting Relational Agent for Health Behavior Change in Low and Middle - Income Countries (LMICs): Issues and Approaches. J Med Syst 2019; 43:227. [PMID: 31190131 DOI: 10.1007/s10916-019-1360-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
The use of contemporary technologies in healthcare systems to improve quality of care and to promote behavioral healthcare outcomes are prevalent in high-income countries. However, low and middle-income countries (LMICs) are not receiving the same advantages of technology, which may be due to inadequate technological infrastructure and financial resources, lack of interest among policy makers and healthcare service providers, lack of skills and capacity among healthcare professionals in using technology based interventions, and resistance of the public to the use of technologies for healthcare or health promotion activities. Technology-based interventions offer considerable promise to develop entirely new models of healthcare both within and outside of formal systems of care and offer the opportunity to have a large public health impact. Such technology-based interventions could be used to address targeted global health problems in LMICs, including the chronic non-communicable diseases (NCDs) - a growing health system burden in LMICs. Major preventable behavioral risk factors of chronic NCDs are increasing in LMICs, and innovative interventions are essential to address these risk factors. Computer-based or mobile-based virtual coaches or Relational Agents (RAs) are increasingly being explored for counseling patients to change their health behavior in high-income countries; however, the use of RAs in LMICs has not been studied. In this paper, we summarize the growing application of RA technology in behavior change interventions in high-income countries and describe the potential of its use in LMICs. Finally, we review the potential barriers and challenges in promoting RAs in LMICs.
Collapse
Affiliation(s)
- Md Faisal Kabir
- Department of Computer Science, North Dakota State University, Fargo, ND, 58108, USA
| | - Daniel Schulman
- Philips Research North America, 2 Canal Park, 3rd Floor, Cambridge, MA, 02141, USA
| | - Abu S Abdullah
- Boston University School of Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA, 02118, USA. .,Duke Global Health Institute, Duke University, Durham, NC, 27710, USA. .,Global Health Program, Duke Kunshan University, Kunshan, 215347, Jiangsu Province, China.
| |
Collapse
|
6
|
Virtual Assistant to Improve Self-care of Older People with Type 2 Diabetes: First Prototype. GERONTECHNOLOGY 2019. [DOI: 10.1007/978-3-030-16028-9_21] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
7
|
Holtz BE, Murray K, Park T. Serious Games for Children with Chronic Diseases: A Systematic Review. Games Health J 2018; 7:291-301. [PMID: 29957082 DOI: 10.1089/g4h.2018.0024] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The purpose of this study was to systematically review the literature to assess if serious games impact health outcomes for children less than 18 years of age with chronic diseases. Additionally, the impact of self-efficacy, adherence, knowledge, use of theory, parent involvement, and study quality was also examined. MATERIALS AND METHODS Searches were conducted in databases EBSCO, PubMed, and Web of Science between June and August 2016. Randomized controlled trials using a serious game as an intervention, for participants under 18 years of age, to improve their chronic disease were included. RESULTS Data were extracted by two independent researchers, including: Title, author, and publication year; chronic disease; game description; number and age of participants; intervention duration; significant findings; parent involvement; theory; and study quality. Any disagreements were tackled and consensus was achieved. Eighteen studies were included in the review. The areas of health addressed included cerebral palsy, asthma, diabetes, developmental coordination disorders, and vision disorders. In these articles, eight health outcome variables were measured, including: lung function, glycemic control, hospital visits, motor proficiency, and visual acuity. Psychosocial variables that were assessed included self-efficacy and knowledge. Two articles included parents in the intervention, and three articles used theory. Six studies had significant health outcome finding, and four studies found a significant change in one psychosocial variable. CONCLUSION This review demonstrates the potential for games to improve health outcomes of young individuals. However, the mixed results suggest that more serious game interventions need to be better designed and rigorously tested to support their impact on improving health outcomes.
Collapse
Affiliation(s)
- Bree E Holtz
- 1 Department of Advertising and Public Relations, Michigan State University , East Lansing, Michigan
| | - Katharine Murray
- 1 Department of Advertising and Public Relations, Michigan State University , East Lansing, Michigan
| | - Taiwoo Park
- 2 Department of Media and Information, Michigan State University , East Lansing, Michigan
| |
Collapse
|
8
|
Hilliard ME, De Wit M, Wasserman RM, Butler AM, Evans M, Weissberg-Benchell J, Anderson BJ. Screening and support for emotional burdens of youth with type 1 diabetes: Strategies for diabetes care providers. Pediatr Diabetes 2018; 19:534-543. [PMID: 28940936 PMCID: PMC5862727 DOI: 10.1111/pedi.12575] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 01/09/2023] Open
Abstract
Multiple sources of burden for youth with type 1 diabetes (T1D) impact key outcomes including quality of life, self-management, and glycemic control. Professional diabetes organizations recommend diabetes care providers screen for psychosocial and behavioral challenges and implement strategies to support youth with T1D. The purpose of this article is to review the literature and recommend practical strategies medical providers can use for screening and behavioral support for youth with diabetes and their families. As part of their routine medical care, diabetes care providers are well-positioned to identify and intervene to address emotional distress related to the burdens of living with diabetes. In collaboration with multidisciplinary team members, including psychologists and mental health professionals, medical providers may be able to successfully implement brief behavioral strategies for screening and providing emotional support.
Collapse
Affiliation(s)
- Marisa E Hilliard
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Maartje De Wit
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Rachel M Wasserman
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Ashley M Butler
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Meredyth Evans
- Northwestern University's Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Jill Weissberg-Benchell
- Northwestern University's Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Barbara J Anderson
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| |
Collapse
|
9
|
Hilliard ME, Eshtehardi SS, Minard CG, Saber R, Thompson D, Karaviti LP, Rojas Y, Anderson BJ. Strengths-Based Behavioral Intervention for Parents of Adolescents With Type 1 Diabetes Using an mHealth App (Type 1 Doing Well): Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2018. [PMID: 29535081 PMCID: PMC5871739 DOI: 10.2196/resprot.9147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Supportive parent involvement for adolescents’ type 1 diabetes (T1D) self-management promotes optimal diabetes outcomes. However, family conflict is common and can interfere with collaborative family teamwork. Few interventions have used explicitly strengths-based approaches to help reinforce desired management behaviors and promote positive family interactions around diabetes care. Objective The aim of this protocol was to describe the development of a new, strengths-based behavioral intervention for parents of adolescents with T1D delivered via a mobile-friendly Web app called Type 1 Doing Well. Methods Ten adolescent-parent dyads and 5 diabetes care providers participated in a series of qualitative interviews to inform the design of the app. The 3- to 4-month pilot intervention will involve 82 parents receiving daily prompts to use the app, in which they will mark the diabetes-related strength behaviors (ie, positive attitudes or behaviors related to living with or managing T1D) their teen engaged in that day. Parents will also receive training on how to observe diabetes strengths and how to offer teen-friendly praise via the app. Each week, the app will generate a summary of the teen’s most frequent strengths from the previous week based on parent reports, and parents will be encouraged to praise their teen either in person or from a library of reinforcing text messages (short message service, SMS). Results The major outcomes of this pilot study will include intervention feasibility and satisfaction data. Clinical and behavioral outcomes will include glycemic control, regimen adherence, family relationships and conflict, diabetes burden, and health-related quality of life. Conclusions This strengths-based, mobile health (mHealth) intervention aims to help parents increase their awareness of and efforts to support their adolescents’ engagement in positive diabetes-related behaviors. If efficacious, this intervention has the potential to reduce the risk of family conflict, enhance collaborative family teamwork, and ultimately improve diabetes outcomes. Trial Registration ClinicalTrials.gov NCT02877680; https://clinicaltrials.gov/ct2/show/NCT02877680 (Archived by WebCite at http://www.webcitation.org/6xTAMN5k2)
Collapse
Affiliation(s)
- Marisa E Hilliard
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Sahar S Eshtehardi
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Charles G Minard
- Dan L Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, United States
| | - Rana Saber
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Debbe Thompson
- Children's Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Houston, TX, United States.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Lefkothea P Karaviti
- Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Yuliana Rojas
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Barbara J Anderson
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| |
Collapse
|
10
|
Nasrinpour HR, Reimer AA, Friesen MR, McLeod RD. Data Preparation for West Nile Virus Agent-Based Modelling: Protocol for Processing Bird Population Estimates and Incorporating ArcMap in AnyLogic. JMIR Res Protoc 2017; 6:e138. [PMID: 28716770 PMCID: PMC5537560 DOI: 10.2196/resprot.6213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/12/2016] [Accepted: 06/05/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND West Nile Virus (WNV) was first isolated in 1937. Since the 1950s, many outbreaks have occurred in various countries. The first appearance of infected birds in Manitoba, Canada was in 2002. OBJECTIVE This paper describes the data preparation phase of setting up a geographic information system (GIS) simulation environment for WNV Agent-Based Modelling in Manitoba. METHODS The main technology used in this protocol is based on AnyLogic and ArcGIS software. A diverse variety of topics and techniques regarding the data collection phase are presented, as modelling WNV has many disparate attributes, including landscape and weather impacts on mosquito population dynamics and birds' roosting locations, population count, and movement patterns. RESULTS Different maps were combined to create a grid land cover map of Manitoba, Canada in a shapefile format compatible with AnyLogic, in order to modulate mosquito parameters. A significant amount of data regarding 152 bird species, along with their population estimates and locations in Manitoba, were gathered and assembled. Municipality shapefile maps were converted to built-in AnyLogic GIS regions for better compatibility with census data and initial placement of human agents. Accessing shapefiles and their databases in AnyLogic are also discussed. CONCLUSIONS AnyLogic simulation software in combination with Esri ArcGIS provides a powerful toolbox for developers and modellers to simulate almost any GIS-based environment or process. This research should be useful to others working on a variety of mosquito-borne diseases (eg, Zika, dengue, and chikungunya) by demonstrating the importance of data relating to Manitoba and/or introducing procedures to compile such data.
Collapse
Affiliation(s)
- Hamid Reza Nasrinpour
- University of Manitoba, Electrical and Computer Engineering Department, Winnipeg, MB, Canada
| | - Alexander A Reimer
- University of Manitoba, Electrical and Computer Engineering Department, Winnipeg, MB, Canada
| | - Marcia R Friesen
- University of Manitoba, Electrical and Computer Engineering Department, Winnipeg, MB, Canada
| | - Robert D McLeod
- University of Manitoba, Electrical and Computer Engineering Department, Winnipeg, MB, Canada
| |
Collapse
|
11
|
Redondo MJ, Callender CS, Gonynor C, Cantu D, Cullen KW, Anderson B, Thompson D. Diabetes care provider perceptions on family challenges of pediatric type 1 diabetes. Diabetes Res Clin Pract 2017; 129:203-205. [PMID: 28549297 PMCID: PMC5533938 DOI: 10.1016/j.diabres.2017.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/08/2017] [Indexed: 01/09/2023]
Abstract
Pediatric healthcare providers' perspectives on barriers to diabetes self-management among youth with type 1 diabetes and strategies to overcome them were explored qualitatively. Family conflict about diabetes care was viewed as a common problem, addressable by behavioral interventions to improve communication and promote family teamwork in diabetes management responsibilities.
Collapse
Affiliation(s)
- Maria J Redondo
- Baylor College of Medicine/Texas Children's Hospital. Diabetes and Endocrinology Section. Houston, TX 77030. United States.
| | - Chishinga S Callender
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030. United States
| | - Caroline Gonynor
- Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX 77030, United States
| | - Dora Cantu
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030. United States
| | - Karen W Cullen
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030. United States
| | - Barbara Anderson
- Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX 77030, United States
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030. United States
| |
Collapse
|