Mobile Phone Intervention Research Articles

Effect of using mobile phone communication on dietary management of Type 2 Diabetes Mellitus patients in Kenya.

Advancements in management of non-communicable diseases using regular reminders on lifestyle and dietary behaviors have been effectively achieved using mobile phones. This study evaluates the effects of regular communication using a mobile phone on dietary management of Type 2 Diabetes Mellitus (T2DM) among patients attending Kitui County Referral Hospital (KCRH) in Kenya. Pre/post-study design among eligible and consenting T2DM patients visiting KCRH was used for this study. One hundred and thirty-eight T2DM patients were enrolled; 67 in the intervention group (IG) and 71 in the control group (CG). The IG received regular reminders on key dietary practices through their mobile phones for six months while the CG did not. The Net Effect of Intervention (NEI) and bivariate logistic regression were used to determine the impact of mobile phone communication intervention at p < 0.05. SPSS version 24 was used to analyze the data. The results revealed an increase of respondents who adhered to the meal plan in the IG from 47.8% to 59.7% compared to a decrease from 49.3% to 45.1% in CG with corresponding NEI increasing (16.1%) significantly (p < 0.05). The proportion of respondents with an increased frequency of meals increased from 41.8 to 47.8% in the IG compared to a reduction from 52.1% to 45.1% in the CG with corresponding NEI increasing (13.0%) significantly (p < 0.05). Regular reminders on lifestyle and dietary behaviors using mobile phone communication improved adherence to dietary practices such as meal planning and frequency of meals in the management of T2DM.

Impact of mobile phone intervention on intermittent preventive treatment of malaria during pregnancy in Burkina Faso : A pragmatic randomized trial

PurposeIntermittent preventive treatment of malaria with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP) coverage remains far below the desirable goal of at least three doses before delivery. This study evaluates an innovative intervention using mobile phones as a means of increasing coverage for the third dose of IPTp-SP. MethodsThis study in Burkina Faso was designed as an open-label, pragmatic, two-arm, randomised trial. Pregnant women who attended antenatal clinic (ANC) visits were included at their first ANC visit and followed until delivery. The intervention was built around the use of mobile phones as means ensuring direct tracking of pregnant women. ResultsTwo hundred and forty-eight (248) pregnant women were included in the study. The proportion of women who received at least three doses of IPTp-SP was 54.6 %. In the intervention group, 54.1 % of women received at least three doses of IPTp-SP versus 55.1 % in the control group, a non-significant difference (adjusted odds ratio “aOR”, 0.86 ; 95 % confidence interval “95 % CI”, 0.49–1.51). Women in the intervention group were more likely to carry out their ANC visits in a timely manner than those in the control group (aOR, 3.21 ; 95 % CI, 1.91–5.39). ConclusionWhile mobile phone intervention did not increase the proportion of women receiving three doses of IPTp-SP, it did help to increase the proportion of timely ANC visits. Trial registrationPACTR202106905150440

Development of a mHealth Intervention (TechCare) for First Episode Psychosis: A Focus Group Study With Mental Health Professionals

AimsResearch in the area of mHealth, has shown much promise in the development of mobile phone interventions which look at the assessment and treatment in real-time of psychiatric disorders. Within the context of Severe Mental Illnesses (SMI), such as psychosis, communication and understanding between health professionals and service users in the reporting of distress and reoccurrence of symptoms is essential in reducing the chances of relapse. An alternative pathway which uses mobile technology to engage with services, may hold the key to gaining a deeper understanding of the lived experiences of those with mental health difficulties, in particular experiences of recovery from SMI's. AIM: The aim of the study was to explore the perspectives and opinions of health professionals on the development and refinement of the TechCare App for psychosis. A qualitative approach was adopted for data collection, which provided an understanding of factors in relation to the development of the intervention.MethodsA total of two focus groups were held with health professionals to elicit their views on optimising the utility of the TechCare App. The total sample size for the focus groups was n = 16 with a total of 6 males and 10 females. This qualitative study was part of a feasibility study, investigating a novel intervention (TechCare) (Husain et al., 2016; Gire et al., 2021) which monitored participants symptoms and provided a tailored psychosocial response in real-time. Data obtained from the focus groups was transcribed. Framework analysis were used to analyse the data for emerging themes, focusing on feasibility, acceptability and further development.ResultsThe key themes that emerged from the data were; access and usage of digital technologies, implications for clinical practice, challenges &amp; barriers to delivery and development and refinement considerations for the TechCare App.ConclusionResults of the focus group with health professionals provided a unique perspective of conducting mHealth research within an EIS context, and the differing challenges professionals anticipated facing in delivering the TechCare App intervention. The main finding of the focus group was that professionals saw the potential for the TechCare App to increase access to digital technologies, providing service users with an alternative medium to communicate with EIS health professionals. However, the participants felt that despite mHealth Apps being a useful platform to deliver interventions, face-to-face contact should remain an important aspect of routine care.

Use of a mobile application for remote monitoring of patients with chronic heart failure in clinical practice

The steady growth and prevalence of chronic heart failure (CHF) leads to an increase in mortality, repeated hospitalizations and disability of the population. More than half of rehospitalizations are due to poor adherence to therapy, the impossibility of timely observation by a doctor, and inadequate patient education in the basics of self-control and self-help during and after discharge. In order to improve the quality of life of patients with CHF, reduce the frequency of readmissions and mortality, it is necessary to create programs to optimize outpatient care with the possibility of monitoring clinical indicators and timely correction of therapy, which can be done using digital technologies — mHealth. The ubiquity of mobile phones and portable gadgets is thought to make the introduction of remote monitoring software more affordable and cost effective. Thus, the purpose of the review is to collect and analyze the available literature data on the use of mobile technology programs for non-invasive remote monitoring of patients with CHF. Thus, studies investigating the impact of remote monitoring on the course of CHF have included widely varying patient cohorts using dissimilar devices with different support packages. Of course, the heterogeneity of both the sample and the methods used led to the inconsistency of the data obtained, the inability to compare and evaluate the results in full. Along with this, the inability to directly compare different methods of remote monitoring of patients with CHF determines the impossibility of choosing the most effective of them, which, in turn, dictates the need for standardization of methods according to, including the healthcare system in each individual country. Overall, mHealth applications offer a potentially cost-effective solution with continued access to symptom monitoring, encouraging patient engagement in self-care and self-monitoring, and improved outcomes over standard practice. While there is considerable evidence for the effectiveness of remote monitoring programs, many areas of uncertainty remain, and mobile phone interventions require further careful evaluation. Although the available data is insufficient to confirm the impact of mobile phone monitoring, it is clear that the potential is enormous.

Community-engaged mHealth intervention to increase uptake of HIV pre-exposure prophylaxis (PrEP) among gay, bisexual and other men who have sex with men in China: study protocol for a pilot randomised controlled trial

IntroductionThe large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges...

Bibliographic Analysis of Medication Adherence and Use of Reminders

The study aimed to highlight the work of different researchers and publication platforms in disseminating knowledge about medication adherence and the use of reminders. The trend of publication, prominent contributors, funders, countries, and shift in the use of reminders was encompassed based on bibliographic and text analysis. Articles published in the last ten years between 2011 to 2020 were extracted from the Scopus database. Data of 1007 articles were analysed in VOS viewer to obtain graphs and network diagrams. Most of the research was done in the United States (526 documents). The research conducted by Harvard Medical School had the maximum number of publications (42). In recent years there has been active publication from the countries like Norway, France, Singapore and China. It was also found that studies at the beginning of the decade were mainly focused on SMS and mobile phone interventions. The trend has shifted towards intentions like mobile applications, and the term “mhealth” is used more in the current years.

The Use of Mobile Phones in Classrooms: A Systematic Review

The inclusion and use of mobile phones in education is subject to two opposing arguments, one which defends and the other which opposes their use. This work has undertaken a systematic revision of scientific production to guide researchers in their enquiries into this subject. To achieve this, a total of 60 articles indexed to the Journal Citation Reports database between the years 2011 and 2020 have been analysed. These have been categorised in six specific areas: attitude and relationship with the mobile phone, communication, educational applications and classroom interventions, tension between agents, relationship between use and performance and problems deriving from their use. The conclusions of the analysis made show that, in general, scientific production would seem to back the introduction of mobile phones in classrooms as beneficial for educational purposes provided that certain preliminary work is carried out and a certain development is achieved of the digital and media skills of both students and teaching staff.

Using mobile phone applications in engaging nurses for preventing healthcare-associated infections: A systematic review

Background &amp; Aim: Prevention of healthcare-associated infections targets health workers. Considering the crucial role of nurses, potential applications of mobile phone-based interventions are innovative, attractive, and easily accessible. This study synthesizes mobile applications with the involvement of nurses or nursing students in outcomes to prevent healthcare-associated infections and their implications.&#x0D; Methods &amp; Materials: Systematic review, database searches included: SCOPUS, EBSCO MEDLINE, PubMed, ProQuest, Institute of Electrical and Electronics Engineers, and SagePUb. Population involved nurses or nursing students with mobile-based interventions about healthcare-associated infections. Quantitative design focused on publications between 2015-2021. Methodological quality applied the Cochrane and the National Heart, Lung, and Blood Institute tools. Analysis used narrative synthesis.&#x0D; Results: 11 studies met inclusion criteria from 1,792. Study populations were heterogeneous. Mobile phone interventions included: short message service (18.2%), (9.1%), mobile and computer access (18.2%), and iOs/Android-based (27.3%). healthcare-associated infections prevention focused on: surgical site infections (54.5%), central line-associated bloodstream infections (9.1%), catheter-associated urinary tract infections (9.1%), antimicrobials (9.1%), knowledge, attitude, and practice towards healthcare-associated infections (18.2%). Most bias risks were moderate to high. Participants showed positive responses. All studies described problems in implementing healthcare-associated infections applications. Five studies reported estimated cost savings.&#x0D; Conclusion: Using mobile phone applications has involved nurses as researchers, participants, and intervention providers to patients. The impact is promising in preventing healthcare-associated infections. Response of user is influenced by technology familiarity, which involves interactive features and problem anticipation. This review showed significant cost savings, so stakeholders and future research plans can consider it.

Effect of a workplace mobile phone-based instant messaging intervention on smoking cessation: a cluster-randomized controlled trial.

To test the effectiveness of intractive, instant messaging chat-based mobile phone support versus text-based mobile phone support integrated with brief interventions on self-reported smoking abstinence in workplaces. A two-arm parallel cluster-randomized controlled trial with follow-up to 12 months. Seventy-five companies in Hong Kong, China. Daily cigarette adult smokers (92.0% male, 90.9% not ready to quit within the next 30 days) from 75 companies (clusters). Participants were cluster-randomized to receive text-based support (TBS, n = 375; 38 clusters) or chat-based support (CBS, n = 304; 37 clusters). TBS participants received automated and fix-scheduled text messages on cessation advice and support. CBS participants received fix-scheduled text messages and additional real-time psychosocial and cessation support via instant messaging services (e.g. WhatsApp) by counsellors. Both groups received a 1-hour health talk at baseline and brief telephone counselling at 1week and 1, 3, 6 and 12 months. The primary outcome was self-reported 7-day point-prevalence abstinence at 6months post-treatment initiation. Secondary outcomes included 7-day point-prevalence abstinence at 12 months, repeated 7-day point-prevalence abstinence, smoking reduction, quit attempts and intervention engagement, defined as having read text messages and/or engaged in conversation with counsellors. By intention-to-treat assuming that dropouts were smoking, self-reported abstinence was not significantly different between the CBS and TBS groups at 6months [18.8 versus 21.6%, risk ratio (RR) = 0.87, 95% confidence interval (CI) = 0.61, 1.23, retention = 71.3%] and 12 months (21.4 versus 24.0%, RR = 0.90, 95% CI = 0.66, 1.21, retention = 70.8%). The repeated 7-day point-prevalence abstinence, smoking reduction and quit attempts were similar between the groups. The participants who were engaged in the text- and/or chat-based interventions had greater abstinence (adjusted RR = 2.91, 95% CI = 1.87, 4.52) at 6months compared with unengaged participants. Compared with a text messaging mobile phone intervention, a chat-based instant messaging mobile phone intervention did not improve smoking abstinence over 12 months in workplaces. Engagement in text-based or chat-based interventions was associated with higher quit rates compared with non-engagement.

Effectiveness of Mobile Phone and Web-Based Interventions for Diabetes and Obesity Among African American and Hispanic Adults in the United States: Systematic Review.

BackgroundMobile health (mHealth) and web-based technological advances allow for new approaches to deliver behavioral interventions for chronic diseases such as obesity and diabetes. African American and Hispanic adults experience a disproportionate burden of major chronic diseases.ObjectiveThis paper reviews the evidence for mHealth and web-based interventions for diabetes and obesity in African American and Hispanic adults.MethodsLiterature searches of PubMed/Medline, The Cochrane Library, EMBASE, CINAHL Plus, Global Health, Scopus, and Library & Information Science Source were conducted for relevant English-language articles. Articles identified through searches were reviewed by 2 investigators and, if they met the inclusion criteria, were extracted and assessed for risk of bias. Findings were summarized in tabular and narrative format. The overall strength of the evidence was assessed as high, moderate, low, or insufficient on the basis of risk of bias, consistency of findings, directness, precision, and other limitations.ResultsSearches yielded 2358 electronic publications, 196 reports were found to be eligible for inclusion, and 7 studies met the eligibility criteria. All 7 included studies were randomized control trials. Five studies evaluated the effectiveness of an mHealth intervention for weight loss, including one that evaluated the effectiveness for diabetes and two studies focused on diabetes. Of all the studies that focused on weight loss, 3 reported significant differences in weight loss in participants in the intervention group compared with those in the usual care group. Although all studies on diabetes control showed greater improvement in glycemic control for the intervention group compared to that in the control group, only one study showed a significant difference between the 2 groups.ConclusionsThis analysis indicates that there are few published studies that assessed mHealth interventions among minority populations and focused on weight or diabetes. Although the overall strength of evidence was low for diabetes control, it was moderate for weight loss, and our findings suggest that mHealth and web-based interventions may provide a promising approach for interventions among African American and Hispanic adults who have obesity or diabetes.

Feasibility, Acceptability, and Potential Cost-Effectiveness of a Novel Mobile Phone Intervention to Promote Human Immunodeficiency Virus Testing Within Social Networks in Tanzania.

Among 145 individuals surveyed in Tanzania, 42% indicated willingness to test for human immunodeficiency virus in response to a confidential, phone-based text message. On average, participants were likely to provide contact information for 1.5 members of their social networks, suggesting high feasibility and moderate acceptability of a novel mHealth human immunodeficiency virus testing intervention.

Mobile phone interventions to promote adherence to HIV treatment: mitigating the challenges.

Mobile phone interventions are often used in healthcare for sharing information and interacting with patients regarding their treatment and care. In people with human immunodeficiency virus (HIV), antiretroviral treatment is crucial and mobile phone interventions are increasingly used to promote adherence to HIV treatment. However, such interventions have potential disadvantages, which nurses and other healthcare professionals need to recognise and mitigate. This article details a literature review that investigated the disadvantages of mobile phone interventions designed to promote adherence to treatment among people with HIV. Four themes were identified from the literature: issues with confidentiality of HIV diagnosis, frustrations associated with technical issues, lost or stolen mobile phones, and the importance of professional support. Nurses involved in caring for patients with HIV should seek to mitigate these disadvantages, regularly review the effectiveness of mobile phone interventions and ensure that each patient receives personalised support. Further research into existing and new mobile phone-based methods of patient support is warranted.

Effects of community-based interventions on exclusive breastfeeding among lactating women: a systematic review

Improvement in the exclusive breastfeeding (EBF) rates until 6 months have been proved to be a major contributor in the improvement of child survival over last two decades because EBF provides optimal nutrition for early life. However, most of the low-income countries (LIC) and low-middle income countries (LMIC) are below the 90% benchmark set by World Health Organization. Evidence regarding CBIs for EBF among lactating women with infants &lt;6 m was searched in PubMed and Cochrane library. Studies from LICs and LMICs that reported EBF until 6 months as outcomes were included and their results were analysed. Data extraction included characteristics of the studies and full summary that involved the effect of interventions on the outcomes. Of 5,530 studies initially identified, 25 studies were included for the systematic review. The interventions were community-based that focused on breastfeeding practices among lactating women with infants &lt;6 m. The studies were geographically diverse-involved LICs (n=7) and LMICs (n=11). The population ranged from n=12 to 26,262. Of 25 studies, five types of interventions reported- counselling interventions (n=14), training to peer counsellors (n=2), mass media interventions (n=5), mobile phone Interventions (n=1), and EBF promotion and education (n=3). CBIs could substantially increase the rates of EBF. The review identified five types of CBIs, indicating that there are different ways through which high EBF rates could be achieved. Counselling intervention was more effective but other interventions have also shown significant results in improving BF practices.

Using Smartphone Applications to Manage Chronic Conditions in Older Adults – A Review on Level of Evidence

Background: From health monitoring to health education and from behaviour change to falls sensing and health alerts to the simple pleasure of communication and connectedness, the mobile technologies (smartphone applications) are changing the lives of older adults.Objective: To examine current evidence of use of smartphones by older adults for health purposes (including communication, education, and health monitoring), and understand gaps and challenges in order to inform the design of future systems given the ubiquity of mobile phone technology.Methods: MEDLINE, CINAHL and Google scholar databases were searched from October 2016 to January 2017. Keywords used include ‘smartphone apps’, ‘mobile phone’, ‘chronic disease’, ‘chronic condition’, ‘older adults’ and ‘elderly’. A total of 12 articles were selected for quality assessment and grading of evidence.Results: Twelve different articles were found and categorized into nine different clinical domains with specific health related interventions. Articles were focused on diabetes care (2 articles), followed by COPD (2 articles), heart disease (1 article), Alzheimer’s/dementia Care (2 articles), osteoarthritis and pain management (1 article), fall prevention (1 article), colon cancer (1 article), palliative care (1 article), chronic kidney disease (1 article). Areas of interest studied included feasibility, acceptability, functionality and thereby determining their effectiveness. There were many different clinical domains; however, most of the studies were pilot studies. Current work in using mobile phones for older adult use are spread across a variety of clinical domains. Findings from different studies indicate that the use of mobile phone interventions has the potential to support successful management of chronic conditions and health behaviour change in older adults.Conclusion: Perceived benefits and willingness to use the smartphone apps are high; however, technical training and cost are main concerns. A common problem with elderly users was their reluctance to press buttons due to the fear of breaking something which has been resolved by touch screen technology of the smartphones. However, the advanced user clicked around the screen until he found what he was looking for, while the others spent a lot of time observing the screen and trying to determine the correct step. Promotion of user-friendly apps are expected especially for older adults having a diminished physical and cognitive abilities.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 381-387

Mobile Phone Intervention Based on an HIV Risk Prediction Tool for HIV Prevention Among Men Who Have Sex With Men in China: Randomized Controlled Trial

BackgroundeHealth interventions based on risk stratification have not been extensively applied for HIV behavioral interventions among HIV-negative men who have sex with men (MSM).ObjectiveThis study aimed to evaluate the efficacy of a mobile phone intervention based on an HIV risk prediction tool in promoting HIV testing and reducing high-risk behavior among HIV-negative MSM in China.MethodsWe performed a mobile phone–based randomized controlled clinical trial for 12 weeks. A comprehensive intervention package deployed on Jinshuju—an online survey platform—was developed and consisted of 4 components: (1) a validated HIV risk prediction tool that provides information on personalized risk reduction interventions; (2) a map of individualized HIV testing facilities based on their geographic location; (3) a QR code for free resources on HIV prevention, including condoms and HIV self-testing kits; and (4) general resources for HIV health education. MSM participants recruited from WeChat/QQ groups were randomly assigned to the intervention or control group at a 1:1 ratio. The staff sent the QR code for the comprehensive intervention package to MSM in the intervention group over WeChat and sent the QR code only for the resources on HIV health education to those in the control group. At baseline and 12-week follow-up, data on HIV-related risk behavior and HIV testing behavior were collected through the Jinshuju online survey platform.ResultsIn total, 192 MSM were recruited and assigned to the intervention or control group (n=96 each). At week 12, the total clinical trial retention rate was 87.5%. The number of male sexual partners of the MSM in the past 3 months was significantly lower in the intervention group than in the control group (3.51, SD 4.1 vs 6.01, SD 11.4, respectively; mean difference −2.5; 95% CI −5.12 to 0.12; P=.05); the rate of condom use with casual sexual partners was higher in the intervention group than in the control group (87%, n=66/76 vs 70%, n=54/77 respectively; odds ratio 2.81, 95% CI 1.23-6.39; P=.01). The proportion of individuals intending to undergo HIV testing after in the following 30 days was marginally higher in the intervention group than in the control group (90%, n=77/86 vs 79%, n=65/82 respectively; odds ratio 2.20, 95% CI 0.90-5.35; P=.07). The incremental cost-effectiveness ratio of eHealth intervention was US $131.60 on reducing 1 sexual partner and US $19.70 for a 1% increment in condom usage with casual partners.ConclusionsA comprehensive intervention based on an HIV risk prediction tool can reduce the number of male sexual partners among MSM and increase the rate of condom use with casual partners. Hence, this intervention is a very promising preventive strategy for HIV among MSM, especially in areas with a prominent HIV epidemic.Trial RegistrationChinese Clinical Trial Registry ChiCTR1800017268; http://www.chictr.org.cn/showprojen.aspx?proj=29271

The MOSEXY trial: mobile phone intervention for sexual health in youth—a pragmatic randomised controlled trial to evaluate the effect of a smartphone application on sexual health in youth in Stockholm, Sweden

An estimated 350 million cases of STIs occur globally each year. In Sweden, Chlamydia is the most common STI with approximately 30 000 cases annually, disproportionally affecting youth. National surveys...

Effect of a mobile phone intervention for female sex workers on unintended pregnancy in Kenya (WHISPER or SHOUT): a cluster-randomised controlled trial

Female sex workers in low-income and middle-income countries face high risks of unintended pregnancy. We developed a 12-month, multifaceted short messaging service intervention (WHISPER) for female sex workers in Kenya who had the potential to become pregnant, to improve their contraceptive knowledge and behaviours. The aim of this study was to assess the effectiveness of the intervention to reduce the incidence of unintended pregnancy among sex workers in Kenya compared with an equal-attention control group receiving nutrition-focused messages (SHOUT). Our two-arm, cluster-randomised controlled trial was done in sex-work venues in two subcounties of Mombasa, Kenya (Kisauni and Changamwe). Participants, aged 16-34 years, not pregnant or planning pregnancy, able to read text messages in English, residing in the study area, and who had a personal mobile phone with one of two phone networks, were recruited from 93 randomly selected sex-work venues (clusters). Random cluster allocation (1:1) to the intervention or control group was concealed from participants and researchers until the intervention started. Both groups received text messages in English delivered two to three times per week for 12 months (137 messages in total), as well as additional on-demand messages. Message content in the intervention group focused on promotion of contraception, particularly long-acting reversible contraception and dual method contraceptive use; message content in the control group focused on promotion of nutritional knowledge and practices, including food safety, preparation, and purchasing. The primary endpoint, analysed in all participants who were randomly assigned and attended at least one follow-up visit, compared unintended pregnancy incidence between groups using discrete-time survival analysis at 6 and 12 months. This trial is registered with Australian New Zealand Clinical Trials Registry, ACTRN12616000852459, and is closed to new participants. Between Sept 14, 2016, and May 16, 2017, 1728 individuals were approached to take part in the study. Of these, 1155 were eligible for full screening, 1035 were screened, and 882 were eligible, enrolled, and randomly assigned (451 participants from 47 venues in the intervention group; 431 participants from 46 venues in the control group). 401 participants from the intervention group and 385 participants from the control group were included in the primary analysis. Incidence of unintended pregnancy was 15·5 per 100 person-years in the intervention group and 14·7 per 100 person-years in the control group (hazard ratio 0·98, 95% CI 0·69-1·39). The intervention had no measurable effect on unintended pregnancy incidence. Mobile health interventions, even when acceptable and rigorously designed, are unlikely to have a sufficient effect on behaviour among female sex workers to change pregnancy incidence when used in isolation. National Health and Medical Research Council of Australia.

Intervention through Short Messaging System (SMS) and phone call alerts reduced HbA1C levels in ~47% type-2 diabetics-results of a pilot study.

PurposeDespite extensive research and newer methods of interventions, the incidence and prevalence of diabetes is increasing at an alarming rate. Currently, according to world health organization (WHO) statistics, 422 million individuals are suffering from diabetes worldwide. In India, recent estimates have reported a significant increase in the number of diabetics in the last decade. Poor dietary habits, minimal adherence to treatment regimens, lack of timely education are some of the contributing factors for increasing incidence and huge economic burden; which can be handled by life style behavior modifications backed up by hand holding through continuous education. Prior studies have demonstrated the efficacy of various self-management tools and educational programs in better disease management behaviors among individuals with diabetes. Among various self-management tools, educating the individuals and alerting them using mobile phone calls and short messaging system (SMS) are widely accepted due to (a) the increasing mobile phone users and (b) availability of short messaging systems in local languages in the recent years. Therefore, a pilot study was conducted to determine the benefit of educating patients through phone calls and SMS in the self-management of diabetes.ObjectivesThe objective of the study is to determine the feasibility and utility of SMS and phone call-based interventions in the management of diabetes by comparing the HbA1c values.MethodologyThe study was conducted for a period of 14 months from December 2017 till Feb 2019. Out of 380 individuals initially enrolled into the study, 120 had completed the 14-months period. Diabetes education through SMS and phone calls was provided on regular basis, and HbA1C levels at baseline, 8-months and 14-months quantified. In addition, feedback on patients’ satisfaction and utility of the SMS / Phone calls was collected using questionnaires.ResultsData from our study demonstrated that after 8-months of intervention through phone calls, a significant increase in the number of individuals with HbA1c in the range of 5.1 to 7.0 was observed (from 27 individuals at base line to 37 individuals after 8-months intervention). Much more significant improvement in the number of individuals with lower HbA1c was observed at 14-months of intervention, indicating the benefit of regular phone call-based system in managing diabetes. A Chi square (χ2) test was performed to examine if the frequencies in the cells varied at baseline and at 8 and 14 months.ConclusionChronic diseases like diabetes needs awareness and education to patients in adopting disease self-management practices. As mobile phone users are increasing in number, providing diabetes management education through mobile phone intervention could be a viable strategy for controlling diabetes.

Pilot Mobile Phone Intervention in Promoting Type 2 Diabetes Management in an Urban Area in Ghana: A Randomized Controlled Trial.

The purpose of the study was to evaluate the feasibility and effectiveness of a nurse-led mobile phone call intervention on glycemic management and adherence to self-management practices among patients with type 2 diabetes mellitus (T2DM) in Ghana. This was a pilot randomized controlled trial to compare diabetes care as usual to a mobile phone call intervention delivered by nurses in addition to care as usual over a 12-week period in a tertiary referral hospital in Ghana. Sixty patients with T2DM were randomized to either the intervention or the control arm. The intervention group received up to 16 mobile phone calls (mean duration = 12 minutes) from a diabetes specialist nurse in addition to their care as usual. The control group received only care as usual. The primary outcome was the change in A1C over the 12-week period. The secondary outcomes were changes in self-reported adherence to medication and diabetes self-management measures over the 12-week period. Mean baseline A1C was comparable between the intervention and control groups (9.54%, SD = 2.00% vs 9.07%, SD = 1.72%, P = .334). After 12 weeks, A1C was significantly lower in the intervention group compared to the control group. The difference in mean A1C in the control group rose by +0.26 ± 1.30% (P = .282; 95% CI, -0.23 to 0.75), whereas that of the intervention group reduced by -1.51 ± 2.67% (P = .004; 95% CI, -2.51 to -0.51). No improvements in self-management were recorded in the control group. In the intervention group, however, the only significant improvement was recorded in the area of foot care practices. Participant recruitment and retention were 100% without any attrition. About 87% (n = 26) of the intervention group completed at least 70% (≥11) of the calls. At the end of the trial, participants who received the intervention rated their satisfaction as 89.3% on average. A mobile phone follow-up call by nurses emphasizing adherence to self-management practices is feasible and can improve short- to medium-term glycemic management among patients with T2DM.

User Perception of a Smartphone App to Promote Physical Activity Through Active Transportation: Inductive Qualitative Content Analysis Within the Smart City Active Mobile Phone Intervention (SCAMPI) Study.

BackgroundPhysical inactivity is globally recognized as a major risk factor for morbidity, particularly the incidence of noncommunicable diseases. Increasing physical activity (PA) is therefore a public health priority. Engaging in active transportation (AT) is a viable approach for promoting daily PA levels. Mobile health interventions enable the promotion of AT to a larger population. The Smart City Active Mobile Phone Intervention (SCAMPI) study was a randomized controlled trial designed to evaluate the ability of a behavior change program delivered via a smartphone app to motivate participants to increase their PA by engaging in AT.ObjectiveThis qualitative study aims to examine the acceptance and user experience of the app promoting AT that was used in the SCAMPI trial (the TRavelVU Plus app).MethodsA total of 17 residents of Stockholm County (13 women; age range 25-61 years) who completed the 3-month app-based behavioral change program (delivered through the TRavelVU Plus app) in the SCAMPI randomized controlled trial during 2018 agreed to participate in a semistructured telephone-based interview. These participants were well representative of the whole intervention group (n=127) in terms of baseline characteristics such as age, sex, and area of residence. The interviews were audiorecorded, transcribed verbatim, and analyzed using an inductive qualitative content analysis.ResultsThe content analysis revealed 2 themes and 4 subcategories. The first theme, “main motivators: monitoring and messages,” highlighted that monitoring AT and being able to set weekly goals using the app were the primary motivators reported by study participants. The second theme, “acceptable but modifiable,” reflects that the app was well accepted and effectively encouraged many participants to use more AT. Nevertheless, there were functions in the app that require modification. For example, while the semiautomated travel tracking feature was appreciated, participants found it time-consuming and unreliable at times.ConclusionsThis study contributes novel insight into adults’ experiences of using a mobile app to promote the use of AT. The results showed that the app was well accepted and that self-monitoring and goal setting were the main motivators to engage in more AT. The semiautomated tracking of AT was appreciated; however, it was also reported to be energy- and time-consuming when it failed to work. Thus, this feature should be improved going forward.Trial RegistrationClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837International Registered Report Identifier (IRRID)RR2-10.1186/s12889-018-5658-4