Sweet Talk. Text Messaging Support for Young People with Diabetes. Victoria Franklin Ninewells Hospital, Dundee, Scotland

Transcription

1 Sweet Talk Text Messaging Support for Young People with Diabetes Victoria Franklin Ninewells Hospital, Dundee, Scotland 1

2 NICE Guidelines on the Management of Type 1 Diabetes Intensive Diabetes Management Intensive Insulin Therapy Intensive Personal Support 2

3 The Aim: To create an innovative support network to promote adherence with intensive insulin therapy To be practical and feasible within NHS resources 3 To engage young people

4 4 a behavioural intervention, delivered by text messaging

5 The Theory: Self-efficacy Social Cognitive Theory Health Behaviours Goal Setting Support Tangible Informational Emotional Companionship Text Messaging Service From Sweet Talk : Daily goal related message Weekly goal reminder Sporadic newsletters Responses to patients texts To Sweet Talk: Messages from Patients 5 Enhanced Metabolic Control

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8 Patient Profiling Patients personal details Patients diabetes self-management goal 8

9 Database of Sweet Talk Text Messages Messages categorised according to diabetes selfmanagement tasks blood glucose testing insulin injections healthy eating exercise Each message could be sub-categorised age gender insulin regimen 9

10 Don t 4get 2 inject! 10

11 11 Why not try another BG meter check out with the team next time ur in clinic

12 Fruit,celery or carrot sticks, pretzels, plain popcorn make healthy snax 12

13 13 Boost ur daily activity play ur favourite music and dnz!

14 Diabetes Self Management Goals set in clinic Text-Messages reinforce Goals, promoting diabetes self-management Sweet Talk schedules messages according to patients goal and profile Patients receive daily goal related text-messages. 14 Messages contain tips, reminders, advice, questions & newsletters

15 15 The Randomised Controlled Trial

16 131 Patients Eligible for Participation 34 Declined 5 Excluded 92 Randomised Aged 8-18 years Type 1 DM > 1 year On CIT Allocation Control Group n=28 Sweet Talk & Conventional Insulin Therapy (CIT) n=33 Sweet Talk & Intensive Insulin Therapy (IIT) n=31 16

17 Results: Mean Change in Psychological Measures Self Efficacy for Diabetes Self-Reported Adherence 20 Diabetes Social Support Group 1 CT Group 2 CIT & ST Group 3 IIT & ST -6-8 Group 1 CT Group 2 CIT & ST Group 3 IIT & ST -20 Group 1 CT Group 2 CIT & ST Group 3 IIT & ST No difference in: Diabetes Knowledge, Health Care Climate, 17 Treatment Self-Regulation, Barriers to Self-Care

18 Results: Glycaemic Control 0.4 Mean Change in HbA1 c Group 1: control Group 2: CIT and ST Group 3: IIT and ST 18 Linear Regression adjusted for baseline HbA1 c : reduction of 1.1%

19 Satisfaction survey: Did Sweet Talk help you look after your diabetes? 100 Percentage of Patients % 17.5% % No response Yes No

20 Tangible Support Goal Related Messages Reminding me to take my jags and that Made me more active during the year Stopped eating as much chocolate Made me test my blood sugars more Contact with Diabetes Team I thought it was good, a lot quite useful. If you had a question it was answered very quickly. Clinic Reminders That was helpful. One time I forgot I even had clinic so it reminded us 20

21 Informational Support Before I didn t know you weren t meant to inject through clothes and everything I used to do that Probably learned a lot more about it basically Good, it helped me and told me what to do 21

22 Companionship Support Stuff about what people say is interesting, you think it s just what you feel, but then you think they ve got that as well Peoples suggestions were good, like dancing to Top of the Pops You got to ask questions and hear results from everyone else as well 22

23 Emotional/Esteem Support I think it is encouragement to keep going Did make you want to reach the goal you set for yourself Really happy because they were trying to look after me Got me to keep in line I suppose 23

24 Summary of the Sweet Talk Results: Self-efficacy Social Cognitive Theory Health Behaviours Goal Setting Social Support Tangible Informational Companionship Esteem Text Messaging Service From Sweet Talk : Daily goal related message Weekly goal reminder Sporadic newsletters Responses to patients texts To Sweet Talk: Messages from Patients 24 Enhanced Metabolic Control

25 Conclusions NICE guidelines, 2004: Intensive Diabetes Management Intensive Personal Support Supports Intensive Insulin Therapy Intensive Insulin Low Cost Intervention Intensive Personal TherapyEngages young people Support 25

26 Acknowledgements 26 Diabetes UK Applied Computing Division, Dundee University The Sea Orange TM Medtronic Tayside Paediatric Diabetes Team The Sweet Talk Study patients

27 27 Thank you!