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Complementarity of Digital Health and Peer Support: “This Is What’s Coming”
PURPOSE: This study examined integration of peer support and a Food and Drug Administration-cleared, diabetes management app (DMA) in diabetes self-management support as a scalable model for those with type 2 diabetes mellitus (T2DM). METHODS: Two lay health Coaches delivered telephone-based self-ma...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012094/ https://www.ncbi.nlm.nih.gov/pubmed/36994335 http://dx.doi.org/10.3389/fcdhc.2021.646963 |
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author | Tang, Patrick Y. Duni, Janet Peeples, Malinda M. Kowitt, Sarah D. Bhushan, Nivedita L. Sokol, Rebeccah L. Fisher, Edwin B. |
author_facet | Tang, Patrick Y. Duni, Janet Peeples, Malinda M. Kowitt, Sarah D. Bhushan, Nivedita L. Sokol, Rebeccah L. Fisher, Edwin B. |
author_sort | Tang, Patrick Y. |
collection | PubMed |
description | PURPOSE: This study examined integration of peer support and a Food and Drug Administration-cleared, diabetes management app (DMA) in diabetes self-management support as a scalable model for those with type 2 diabetes mellitus (T2DM). METHODS: Two lay health Coaches delivered telephone-based self-management support to adults (N = 43) with T2DM recruited through a primary group practice. Those eligible were offered no-cost access to DMA for the entire 6-month study. Coaches introduced DMA and contacted individuals by phone and text with frequency dependent on participant needs/preferences. DMA supported monitoring of blood glucose, carbohydrate intake, and medication use, as well as messaging personalized to participants’ medication regimens. Clinical data were extracted from DMA, electronic medical records, and Coaches’ records. Structured interviews of 12 participants, 2 Coaches, and 5 project staff were analyzed using deductive pre-identified codes (regarding adoptability, patterns of use, value added, complementarity, and sustainability) utilizing standard procedures for qualitative analysis. RESULTS: Of the 43 participants, 38 (88.4%) enrolled in DMA. In general, participants used both DMA and lay health coaches, averaging 144.14 DMA entries (structured, e.g., medications, and free form, e.g., “ate at a restaurant” and “stressed”) and 5.86 coach contacts over the 6-month intervention. Correlation between DMA entries and coach contacts (r = .613, p < 0.001) was consistent with complementarity as were participants’ and coaches’ observations that (a) DMA facilitated recognition of patterns and provided reminders and suggestions to achieve self-management plans, whereas (b) coaching provided motivation and addressed challenges that emerged. Mean hemoglobin A1c (A1c) declined from 9.93% to 8.86% (p < 0.001), with no pattern of coaching or DMA use significantly related to reductions. Staff identified resources to coordinate coach/DMA interventions as a major sustainability challenge. CONCLUSIONS: DMA and peer support for diabetes management are compatible and complementary. Additional practice integration research is needed for adoption and scale-up. |
format | Online Article Text |
id | pubmed-10012094 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100120942023-03-28 Complementarity of Digital Health and Peer Support: “This Is What’s Coming” Tang, Patrick Y. Duni, Janet Peeples, Malinda M. Kowitt, Sarah D. Bhushan, Nivedita L. Sokol, Rebeccah L. Fisher, Edwin B. Front Clin Diabetes Healthc Clinical Diabetes and Healthcare PURPOSE: This study examined integration of peer support and a Food and Drug Administration-cleared, diabetes management app (DMA) in diabetes self-management support as a scalable model for those with type 2 diabetes mellitus (T2DM). METHODS: Two lay health Coaches delivered telephone-based self-management support to adults (N = 43) with T2DM recruited through a primary group practice. Those eligible were offered no-cost access to DMA for the entire 6-month study. Coaches introduced DMA and contacted individuals by phone and text with frequency dependent on participant needs/preferences. DMA supported monitoring of blood glucose, carbohydrate intake, and medication use, as well as messaging personalized to participants’ medication regimens. Clinical data were extracted from DMA, electronic medical records, and Coaches’ records. Structured interviews of 12 participants, 2 Coaches, and 5 project staff were analyzed using deductive pre-identified codes (regarding adoptability, patterns of use, value added, complementarity, and sustainability) utilizing standard procedures for qualitative analysis. RESULTS: Of the 43 participants, 38 (88.4%) enrolled in DMA. In general, participants used both DMA and lay health coaches, averaging 144.14 DMA entries (structured, e.g., medications, and free form, e.g., “ate at a restaurant” and “stressed”) and 5.86 coach contacts over the 6-month intervention. Correlation between DMA entries and coach contacts (r = .613, p < 0.001) was consistent with complementarity as were participants’ and coaches’ observations that (a) DMA facilitated recognition of patterns and provided reminders and suggestions to achieve self-management plans, whereas (b) coaching provided motivation and addressed challenges that emerged. Mean hemoglobin A1c (A1c) declined from 9.93% to 8.86% (p < 0.001), with no pattern of coaching or DMA use significantly related to reductions. Staff identified resources to coordinate coach/DMA interventions as a major sustainability challenge. CONCLUSIONS: DMA and peer support for diabetes management are compatible and complementary. Additional practice integration research is needed for adoption and scale-up. Frontiers Media S.A. 2021-09-24 /pmc/articles/PMC10012094/ /pubmed/36994335 http://dx.doi.org/10.3389/fcdhc.2021.646963 Text en Copyright © 2021 Tang, Duni, Peeples, Kowitt, Bhushan, Sokol and Fisher https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Clinical Diabetes and Healthcare Tang, Patrick Y. Duni, Janet Peeples, Malinda M. Kowitt, Sarah D. Bhushan, Nivedita L. Sokol, Rebeccah L. Fisher, Edwin B. Complementarity of Digital Health and Peer Support: “This Is What’s Coming” |
title | Complementarity of Digital Health and Peer Support: “This Is What’s Coming” |
title_full | Complementarity of Digital Health and Peer Support: “This Is What’s Coming” |
title_fullStr | Complementarity of Digital Health and Peer Support: “This Is What’s Coming” |
title_full_unstemmed | Complementarity of Digital Health and Peer Support: “This Is What’s Coming” |
title_short | Complementarity of Digital Health and Peer Support: “This Is What’s Coming” |
title_sort | complementarity of digital health and peer support: “this is what’s coming” |
topic | Clinical Diabetes and Healthcare |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012094/ https://www.ncbi.nlm.nih.gov/pubmed/36994335 http://dx.doi.org/10.3389/fcdhc.2021.646963 |
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